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BULBOUS 2. KNEE 3. APERTURE/SEAL 5. TRAGAL NOTCH 6. HELIX 7. ANTIHELIX 8. CRUS 9. CONCHA/BOWL 10. ANTITRAGUS RIDGE 2017 Starkey Hearing Technologies. PLEASE CALL CUSTOMER SERVICE OR CHECK STARKEYPRO. COM FOR WARRANTY DATES. STEP 2 - PATIENT FILL OUT PATIENT S NAME DOB/AGE AND DATE FIRST NAME LAST NAME PATIENT DOB/AGE HEARING AID HISTORY SERIAL NUMBER RECEIVER SERIAL NUMBER GAIN/STYLE LEFT RIGHT USER INFORMATION MCL L MCL R UCL L UCL R 500KHZ 1KHZ 2KHZ 3KHZ 4KHZ STEP 3 - PRODUCT ADD CANAL LOCK...
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How to fill out starkey earmold remake form:
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Start by providing your personal information such as your name, address, and contact details.
02
Indicate the reason for requesting a remake of the starkey earmold. Include details about the specific issue or problem you are experiencing.
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Provide information about the original starkey earmold, including the date it was made and any relevant order or reference numbers.
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Describe any changes or modifications you would like for the remake. Be specific about the adjustments or improvements you would like to see in the new earmold.
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If applicable, include any additional notes or instructions for the technicians who will be working on the remake.
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Check if there are any supporting documents or paperwork that need to be included with the form, such as audiograms or medical reports.
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Finally, sign and date the form to confirm your request.
Who needs starkey earmold remake form:
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Those who require modifications or adjustments to their existing starkey earmolds for better comfort or functionality.
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Anyone who has lost or damaged their starkey earmolds and needs replacements.
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What is starkey earmold remake form?
The Starkey earmold remake form is a document used to request a remake of an earmold for hearing aids, ensuring that the correct specifications and details are provided for the replacement.
Who is required to file starkey earmold remake form?
Anyone who needs to have an earmold remade, typically an audiologist or hearing professional on behalf of a patient, is required to file the Starkey earmold remake form.
How to fill out starkey earmold remake form?
To fill out the Starkey earmold remake form, provide patient information, specify the reason for the remake, include details of the original earmold, and ensure all necessary signatures are obtained.
What is the purpose of starkey earmold remake form?
The purpose of the Starkey earmold remake form is to streamline the process of remaking earmolds for hearing aids by providing clear and concise information to the manufacturer.
What information must be reported on starkey earmold remake form?
The information that must be reported on the Starkey earmold remake form includes patient identification details, specifications of the current earmold, reasons for the remake, and any additional notes or comments that may be relevant.
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