Complete Your Patient Forms Online

To make your next visit as simple as possible, all your paperwork has been digitalized.

By selecting the form required below you will be able to complete your answers quickly and easily online.

If you need any further guidance, have any questions or need our help filling out any of the forms, please call our friendly team at (325) 437-4730 who will be happy to help you. 

Patient Intake Form
Hearing History Form
Consent For Treatment
Re-Evaluation Form
Advance Beneficiary Notice of Noncoverage (ABN)
Tinnitus Handicap Inventory
Release Records Form

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It’s often the small things that hold us back from making a decision, now is the time to discuss those “things” with one of our audiologists.

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My experience with Holland Hearing from day one was wonderful!How Bill Was ‘Floored’ By The Difference
I first realized that I had a hearing loss 30 years ago when I started to hear a bothersome noise in my ears. I first thought this was tinnitus. The first person that I went to said I had a little high frequency loss and there was nothing that could be done about my tinnitus. Then I started having difficulty accurately hearing certain words, especially in crowds or at a restaurant. As time passed and I knew I needed to get my hearing tested again, my biggest fear was that the tinnitus could not be mitigated and that any devices I needed were financially out of my reach. My experience with Holland Hearing from day one was wonderful! I met with Dr. Sue Ann and was made to feel comfortable. I felt like I was important to her and her staff, and that they would stick with me until I was satisfied that my hearing issues were resolved. Everyone was friendly, professional, patient, and genuinely concerned about my situation and resolving my issues. I was floored at the difference the hearing aids made! The devices had a feature to help me cope with the tinnitus and I quickly realized I had been missing out on so much because my hearing was definitely not what it needed to be and could be. The “quality of life” thing exists and was so vastly improved after getting tested and fitted for hearing aids. And I actually was able to afford them! Holland Hearing had payment options that fit my financial life perfectly. If you’re considering visiting Holland Hearing Center, I would say that you would not find a better group of hearing professionals anywhere else. I had experience in Abilene and in Dallas with other audiologists and their staff were not at all positive. Holland Hearing was outstanding in all elements of what I expected from the experience. Anyone in this area who has any concerns about their hearing needs to drop everything and get an appointment with Dr. Mangrem or Dr. Holland as soon as they can. You will be absolutely pleased with the results.

Bill
‘My family are delighted, and so am I’ – Mr. Bowen’s story
Mr. Bowen first recognized he had a hearing loss while at work a number of years ago. “I was in business meetings and realized I was not really hearing everything I needed to hear,” he says. Initially, he didn’t think a specialist would be able to treat this issue. Like most, he felt it was a problem that everyone had to just deal with as they get older. In any case, he decided to speak to someone at Holland Hearing Center. “This was many years ago when they first opened,” he says. Dr. Kelsi Mangrem assessed his hearing and came up with a solution – advanced hearing technology that would effectively treat his condition. As soon as he left, he witnessed a dramatic change in his experience. And today, he benefits from a range of accessories that are improving his life even further. “Now I can control my hearing aids with my smartphone and use them in ‘restaurant mode’ to reduce background noise,” he says. “I like that they can be updated remotely, and Holland Hearing’s follow up service is great.” But just as important, his work and home life has benefitted from his original decision to see a doctor of audiology. “My business associates, as well as my family, have noticed how much better I am at hearing and are delighted,” he says, adding: “and so am I.” Have you had issues hearing those around you, or know someone else who has? Why not request a call back or write to us with a question, and we can help you today!

A D Bowen
Being a musician is extremely taxing on your hearing…
“I’m a singer and I’ve sung I don’t know how many times in Abilene over the last 30 years. I came here for my most important stop, Holland Hearing Center. I have severe hearing loss from loud music and shooting guns. I hope if you have hearing loss that you should take my word, I could go anywhere in the world, I choose to come to Abilene to Holland Hearing Center.”

Gary Morris – Legendary Country Artist
It is wonderful to be able to hear again.Nancy Shares Her Difficult Previous Experiences and How Holland Hearing Helped
At age 62 years old, I had my first hearing test and learned I had lost the high pitch sounds in my left ear. It was a bit scary but as I continued to lose more hearing in that ear and some in my right ear, it really started hindering my association with family and friends, making me uncomfortable because I had to ask them to repeat their conversation to me. Because I am very claustrophobic and had been treated harshly when attempting to have further hearing tests at two or three different places throughout the years, I was very scared and hesitant about having a hearing test. In fact, I wouldn’t have gone for another hearing test, but after hearing me say, “Huh?” and, “What?” to almost every sentence, my husband called Holland Hearing without asking me. I found the experience excellent! Dr. Mangrem was extremely patient and understanding with me, making the whole experience very pleasant. For five years prior to my appointment, I had worn a hearing amplifier in my left ear that I had purchased through the mail. It helped me hear a little better but there were disadvantages. It required batteries and the device would squeal loudly when that ear was pressed when hugging, etc. With the ReSound Hearing Aids I purchased at Holland Hearing, both of those problems were eliminated. I hadn’t realized how much I was missing. It is wonderful to be able to hear again. If you’re considering Holland Hearing Center, my advice to you is to make an appointment and give them a chance to give you back as much hearing as possible. It will change your daily life.

Nancy
‘A wonderful, professional, personalized service’ – Noel’s story
Like a lot of people, Noel was aware that his hearing had been fading for years. But he hadn’t done anything about it. For a variety of reasons, hearing loss can be a difficult health issue to confront. It’s not something that’s frequently discussed in public – and often close family members are the first to recognize there’s a problem. In Noel’s case, he wasn’t sure where to seek help or who would be the right person to address his particular concerns. But this changed instantly when he met Dr. Sue Ann Holland. “She was so caring, competent, and considerate that I wished I had visited her earlier,” he says. In particular, he valued the way Dr. Holland tailored his treatment directly to his needs, using her expert knowledge to uncover his hearing problem. "It was a wonderful experience; a professional, personalized service – and that’s ideal!” he says. The treatment that Dr. Holland offered him made a huge difference to his life experiences and, in particular, the way he was able to interact with loved ones. “Now that my hearing deficit has been solved, I’m not missing out on conversations anymore!” he says. Today, Noel has a simple message for any future patients with worries: “Anyone doubting their hearing should head for Holland Hearing!” he says. Are you concerned about a hearing loss, or know someone else who is? Why not request a call back or write to us with a question, and we can help you today!

Dr. Noel Chant
How Hearing Loss Was Impacting Richard ImgrahamRichard’s Advice for Anybody That Thinks ‘Hearing Aids are for Old People’
I first noticed that I might have a hearing loss when my wife said I never listen anymore. I had noticed some ringing in my ears and some tone loss but prior to my appointment with Holland Hearing Center, I believed my hearing loss was just a part of getting old and that hearing devices were too intrusive and annoying for me to be comfortable with them (which I now know not to be true – I barely notice they’re there unless I fidget with them). My experience at my first appointment was awesome. I had decided to address my issue with a new attitude – be honest and accept the inevitable. I did not realize that I only had a certain frequency loss. The enhancement of that is amazing. Wearing hearing aids means that I can now comfortably play and listen to music. I’m so amazed at the difference in the sound quality I can hear. And as for my wife, she loves me more because I am not ignoring her unintentionally. Because they are Bluetooth connected to my phone, I can better listen to phone calls, the radio, sports, and even meditation therapy. My advice to you is that hearing aids are not just for old people. Everyone at any age needs the most optimal capability of any of our senses given to us by God. Vision, dental, or even hearing. Holland Hearing understands this and I found them to be very patient and educational. Please don’t short yourself on the best quality of life. Richard
How Holland Hearing has changed Santiago's life
“My hearing loss journey started when I first heard ringing in my ear, my biggest concern was not being able to find treatment but my experience at Holland Hearing finally found an answer. Dr. Kelsi Mangrem explained everything and answered all my questions. She was very patient with me and made sure that I understood everything about the hearing loss. Straight away, I could see the difference and it has totally changed my life, not being able to hear was very frustrating and I didn’t realize how much of a difference the hearing aids would make, I totally love them. I totally recommend Holland Hearing, the staff is super friendly and they work with you.” Santiago Cano