Hearing Aid Repair Order Form | Hearing Haven
Hearing Aid Repair
Hearing Haven home Hearing aid repair services Meet our staff Hearing aid testimonials Hearing, and hearing aid articles Hearing aid repair order form Contact us
Hearing Haven

Mail In order form

Click here for a printable order form.

Pay Online

Click here to pay online.

Online Order form

*Shipping and contact Information:

*Fields marked with an asterisk are required.
*First Name:
Middle Name:
*Last Name:
Title:
*Address:
*City:
*State:
Province:
*Postal Code:
Country:
*Day Phone #:
Eve. Phone #:
Day Ext.:
Eve. Ext:
*Email Address:
Contact Me By:
privacy policy
How did you find us?

What is the problem with the hearing aid?

L R  
Symptom:
 L R
Symptom:
 L R  
Symptom:
Dead
 Feedback (whistling)
 
Intermittent
 Distorted Volume Control
Weak
 Noise/Static Case Damage
High battery drain
 Motorboating Fit Is Too Loose

*Repair Options:

L R Requested Services:
Aid Is In Warranty With Hearing Haven
Repair ~ $175 per hearing aid
Re-case ~ $275 per hearing aid (info on re-casing)
Next Business Day Turnaround ~ $20 (not available on re-cases)
Express shipping (1-2 day delivery time) ~ $18
Include a hearing aid dryer kit ~ $15

Programming Options

There is no charge for programming if requested at time of repair; otherwise, programming charges are $50 for one hearing aid, or $75 for two hearing aids.

We will not change the programming of your hearing aid(s) unless this section is marked, or unless you have given us specific directions elsewhere to change the programming.

L
R
Requested Action
Re-program aids to the included audiogram (hearing test)

Hearing Aid Cloning:

(info on cloning)

Battery Orders

Batteries are $29 per carton of 40 batteries.

Battery Size:     How many cartons?

*Payment Method:

Call when repaired - I will pay over the phone
A check or money order is enclosed
I will pay online
Other

Enter the text shown into the box below before submitting: verify

Click only once please.

Ship Your Hearing Aid(s) To:

Hearing Haven
3044 Old Denton Road #111-311
Carrollton, TX 75007

************IMPORTANT************

Put your hearing aid into a hard container such as a prescription pill bottle, vitamin bottle, or a hard box.
You can place that into a box or padded envelope, but please don't mail your hearing aid in only a padded envelope.
Your hearing instrument will be protected much better this way.
Solution Graphics