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Physicians,

Thank you so much for trusting us with your patient referrals. We are happy to offer your patients free audiological assessments (including otoscopy, tympanometry, pure tone and bone conduction testing, and a comprehensive suite of speech testing). We will promptly provide your office with a report once the appointment has been attended.

Please feel free to use one of the following to put your patients in touch with us:

  • Download the Physician Referral Form for your office here

  • Or, fill out the below information box, and our office will contact your patient

Phone: (780) 533-3444
Fax: (780) 533-2265

Audiological Assessment: Confidential Patient Referral Form for Physicians

Is this an urgent medical request?

Thank you for submitting your referral. Our office will contact your patient within one business day and provide the report to your office once the appointment is complete.

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