Patient Forms

Useful Information regarding your visit to our practice!

Forms to download and completed prior to your appointment.

Forms to download and completed prior to your appointment.

Form that allows the release of your medical records.

Want to Schedule An Appointment?

Call us at (703) 534-4344 or fill in the appointment form...

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4.8
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Fairfax Hearing Center NOVEL COVID- 19 Update

We know the current situation is unsettling and hope that you are finding ways to practice self-care. We have been carefully monitoring the health and safety updates related to the Coronavirus (COVID-19), and while we have taken many precautions to date, the safety of our patients and staff is most important.

We currently are open and seeing patients. Please call or email us for an appointment. If you are in need of supplies, including batteries, they can be picked up curbside or mailed to you for a nominal fee.

We appreciate your loyalty, patience, and understanding. Please stay safe and take care of yourselves and your families as we all weather this time of uncertainty together. We will continue to communicate with you through social media and email.