Hearing aid consumables order form

We offer our patients a Click and Post Service. We can deliver hearing aid accessories straight to your door by post.

Fill out the form below and click submit. Your form will be sent to the audiology team, and we will post your accessories out to you within one week.

This service is for patients who have hearing aids issued at our hospitals. We are unable to provide accessories for hearing aids that were not obtained from us.

We only send new hearing aid accessories when they are due (e.g. every six months for tubes). If we receive an early request for the hearing aid accessories we may contact you.

							
																			Hearing aid consumables order form
												
							First Name						

							Last Name						

							Address						

							Email						

							Tel No.						

							Date of birth (dd/mm/yyyy)						

							Hearing aid accessories required						
  Tubing
  Batteries
  Cleaning wires (suitable for thin-tube hearing aids only)
  Wax guards (suitable for ITE aids only)

							Which hospital issued the hearing aids?						

Barnet

Chase Farm

Royal Free

							Would you be happy to receive a questionnaire via email about your experience of click and post? We won't share your details with anyone.						

No

Yes

To learn how we collect sensitive information on this website please read the section titled 'sending information to our site' in our terms and conditions. To learn how we use information gathered while providing your healthcare please read our privacy statement.