Hearing Aid Repair Form Download

Please choose the form you would like to use below. On the left is the form designed to be printed first and then filled out by hand. On the right is the form designed to be filled out on the computer first and then printed. Both versions are available in microsoft word format and Adobe PDF format. If you need the free Adobe PDF viewer click here.


Fill out by hand

Fill out on computer


Download Repair Form

Download Repair Form

Download Repair Form

(doesn’t work with older versions of Word)

Download Repair Form

Ship Your Hearing Aid(s) To:

Hearing Haven
3740 North Josey Lane
Suite 125
Carrollton, TX 75007

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

Put your hearing aid into a hard container such as a prescription pill bottle or vitamin bottle. 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.  Shipments outside of the US are subject to additional shipping fees.  Please call customer service for shipping fees.

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