HEARING AID REPAIR FORM

Over The Ear and all other aids we sell.
SORRY, WE DO NOT REPAIR CUSTOM MADE HEARING AIDS

PRINT THIS FORM ON YOUR PRINTER

This form must be filled out and returned with your hearing aid
before we can do any repairs to the hearing aid.

Your name
_________________________________________________________________________________

Your phone #
__________________________________________________________________________________

Your Address ___________________________________________________________________________________
 

_____________________________________________________________________________________
 

What was the date of purchase? _________________________________________________

Please explain what's wrong with your hearing aid.

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Note! We charge a flat $15.00 fee to return the hearing aid to you. (Per Box)
If the hearing aid is in warranty please include a check for that amount.
If the hearing aid is out of warranty, make sure we have your telephone # above.
We will call you with an estimate and you can pay with credit card or check.

Mail To:

Heareasy Hearing Aids
23800 Sunnymead Blvd. Unit C
Moreno Valley, Ca. 92553
951-601-2227

Note! The US Post Office has free priority shipping boxes.