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If your Audiologist has adviced you a hearing aid you can fill in your
audiometery report & get our professional advice
 
 

 
Bone Conduction Air Conduction INTENSITY
Hz. 		Air Conduction Bone Conduction
  Left Ear   Right Ear  
125
250
500
1000
2000
4000
6000
8000
         
 
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*Name
*Age
*Gender Male    Female
Address
E-mail
*Phone
*Dr. Name
*Dr / Aud. Comments
P.S.
If you are unable to fill in the above details, you can mail us a scanned copy or fax us the Audiometry report.

Our recommendation is not binding. The ultimate choice is left to the user.
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