Welcome to our medical questionnaire. Please fill out the questions below by selecting the dropdown option and picking the most appropriate option for your individual hearing situation.
Please read the following before you complete your questionnaire:
1) Please fill out the questions listed below, picking the most appropriate option that applies to you.
2) If you have NOT already sent in your audiogram to Wholesale Hearing, please do so at the end by clicking the attachment icon at the bottom left corner of the box at the end of the page.