RE-PROGRAM AID

HOW TO HAVE YOUR HEARING AID RE-PROGRAMMED

If you need to have your hearing aid re-programmed please print this form and mail it and the hearing aid in a padded b
Heareasy Hearing Aids
13237 Allan Lane
Lillian, Alabama 36549
Phone- 1-951-235-4156

Note! programmable hearing aids can be turned up and down however, if your hearing aid is programmable it is very
sophisticated in it's ability to process sounds. Below, please fill out the information as best as you can.

We need to know if you can hear soft sounds in a quiet room?
We need to know if the voices are ok in a quiet room?
We need to know if your own voice is clear, too loud or fuzzy?
We need to know that (if) the voice is ok in a quiet room, are loud sounds too loud or too soft.
Please add any other information to this form you can think of that you would like us to know.
Also, we need you telephone number and address.
Please send both hearing aids in if you have two and indicate right and left information.
And we will need your complete address.

Note! if your hearing aids are under 60 days old, please add a check for $15.00 (US). -- $35.00 (CANADA)
If your hearing aids are over 60 days old please add a check for $25.00 per aid and $15.00 for shipping (per box)
$35.00 shipping (per box) CANADA
Or you may write your credit card # , expiration and security code here
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