Patient Forms Posted on January 6, 2022 by Kos/Danchak Audiology & Hearing Aids Adult Patient InformationDownload Hearing Health HistoryDownload Protected Health Information AcknowledgementDownload Notice of Privacy PracticesDownload Assignment of Insurance BenefitsDownload New Patient SourceDownload Test Referral FormDownload Neurodiagnostic IntakeDownload Nuerodiagnostic Intake (Spanish)Download Dizziness Handicap InventoryDownload Child History FormDownload What To Expect Do’s And Dont’sDownload Directions to Our OfficeDownload