Forms

Forms must be completed and returned to the UNCG Speech and Hearing Center prior to scheduling an appointment.

Fax: (336) 334-4475

Mail: UNCG Speech and Hearing Center, 524 Highland Ave., 300 Ferguson Building, Greensboro, NC, 27402

New Audiology Patient Forms

Prior to scheduling an appointment to see an audiologist, please complete the following forms:

Patients to be seen at the Tinnitus, Hyperacusis & Misophonia Clinic’s should also complete the following forms:

Patients who wish to be seen for Misophonia should complete the following forms (in addition to the client information and case history forms.)

New Speech and Language Client Forms

Prior to scheduling an appointment to see a speech-language pathologist, please complete the following forms: