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Tell Us a Bit About Your Hearing So That We Can Help You Best

Do you hold any of the following cards?

Pension Concession Card

Veterans DVA Card

Healthcare Card

Seniors Card

None of the Above

Tell us about your hearing

Do you require 1 or 2 Hearing Aids?

1 Hearing Aid 2 Hearing Aids

You're current hearing: Left ear / right ear (i.e is one ear better than the other etc?) *

Do you currently wear hearing aids?

Yes No

If Applicable, Which Hearing Aid brand / model you have tried?

Do you have a preferred Brand (skip if none)?

Are you an active person (eg. self-sufficient, doing own hobbies, interests, social activities)?

Yes No

Tell us more about your lifestyle (required so we can design the right hearing solution for you)* *

*Following your form submission your local Hear for Less endorsed clinic will be in contact with you shortly to arrange your appointment and help you save on your ideal hearing solution

Currency

Step 2 of 2Tell Us a Bit About Your Hearing So That We Can Help You Best

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Tell Us a Bit About Your Hearing So That We Can Help You Best