Paragon Hearing Aid Center

Please enter the patient's information below.

I'm making this appointment for someone else Patient is a current hearing aid wearer Patient Name* Patient Phone* Patient E-mail* Comments, Questions?

Please enter your information below.

Your Name* Your Phone* Your E-mail* Relationship to Patient* I'm the patient's primary contact I will be accompanying the patient to the appointment

Please provide us with details for your Uber voucher below.

Pick-Up Street Address* Pick-Up City* Pick-Up State* Pick-Up Zip Code*

Please confirm your details below and submit to book your appointment. Thank you!

Email Reminder To: Text Reminder To:

Standard text messaging rates may apply

Comments, Questions?