Appointment Booking Form

Preferred Appointment*

Date

Hour MinutesAM/PM Option

Preferred Clinic*

Do you have any of the following?*

Blue Pension CardDVA Gold CardDVA White Card (Hearing Loss)None of the above

You may be eligible for fully subsidised services through Hearing Services Program by the Department of health & aging, please provide details of your requirements and one of our team members will be in touch with you to book an appropriate appointment

Name*

First NameLast Name

Phone Number*

02 1111 1111

Email*

example@example.com

Date of Birth*

Date

Appointments *

Ear Wax RemovalIf you are feeling a blocking sensation in your ears, then this appointment may be helpful. We recommend you use ear wax removal softener a week prior to booking this appointment. Upon examination if no wax found, your audiologist will perform some tests to find out the possible cause for the blocking sensation and guide you for further treatment. Even if you have an eligible pension card, this is a private service and a full fee will be charged. Please note wax removal is not available at Gladstone at the moment

$110.00AUD Payment Options
Item subtotal:$0.00AUD

Hearing EvaluationComprehensive hearing evaluation (may take up to 90 minutes). In this appointment your audiologist will discuss any issues you have with your ears or hearing. They will perform video otoscopy to see how your ear health looks. If needed they may advice for wax removal. They will perform various tests related to your hearing, speech understanding and status of your middle ear. After evaluation audiologist will then explain your results to you and provide you information about the next steps to preserve your hearing and address your hearing needs with tailored solutions.

$130.00AUD
Item subtotal:$0.00AUD

Tinnitus EvaluationIf you are getting and ringing or buzzing sound in your ears, this is the appointment you need to book. This appointment can last up to 90 minutes where your audiologist will take a detailed case history, test your hearing and be able to match the pitch and loudness of your tinnitus. They will also do a few tests to understand the severity of your tinnitus. They will also be able to advise you of the next steps how you can manage your tinnitus better or any further referrals required.

$200.00AUD
Item subtotal:$0.00AUD

Hearing Aid DiscussionIf you are unsure about taking the next step towards getting hearing aids and want to get some expert advice, our audiology specialists can help you narrow down with your choices based on your needs and can also provide a trial with devices, so that you can see for yourself about the benefits before spending your own money. If you decide to proceed with purchase, this fee will be deducted from the total price of the devices. If you don't have a valid audiogram your specialist may need to conduct a comprehensive hearing test and you will be charged for this.

$50.00AUD Quantity

Total

$0.00AUD

Payment Methods

Credit Card

Apple Pay

Comments

Book Appointment

Payment Methods