(845) 395-0300

FORMS

You may download and print these forms and bring them to your first appointment.
For your first appointment, you will need the first two forms and the appropriate history.
You need the Adobe PDF Reader for these documents. If you don't have it, you can download it here.
Financial Responsibility
HIPAA Receipt
HIPAA
Office Policies
Adult History
Pediatric History
Tinnitus History
Pediatric History for Children up to 12 years of age.
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Address:
Lyric Audiology
1200 STATE ROUTE 208, Suite 6
  in the Blooming Grove Plaza
Monroe, NY 10950
lyricaudiology@aol.com
 
Telephone:
(845) 395-0300
 
Fax:
(845) 395-0299