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PRINT THIS FORM ON YOUR PRINTER This form must be filled
out and returned with your hearing aid This is not a form for hearing aid repair. For repairs go to the repair form.
Your phone #
Your Address
______________________________________________________________________
___________________________________________________________________________________
For (Programmable ) hearing aids and hearing
aids costing more
than $400., a 7% charge per order will deducted from your refund
For reconditioned hearing aids, a charge
of 15% will be deducted from your refund plus $7.00 per box shipped if you got
free shipping. NOTE! WE CHARGE A DAILY RENTAL FEE OF $5.00 (PER AID) FOR EACH DAY PAST THE 21 DAY LIMIT. What was the date of purchase? _________________________________________________ How was the purchase made? Credit Card or Check ________________________________ Why are you returning the Hearing Aid? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Are you going to order
another type of hearing aid? _______________________________ Mail To: Heareasy Hearing Aids Note! The US Post Office has free priority shipping boxes. |