unit 4, 15-17 pease street
MANUNDA, CAIRNS
north queensland hearing services
p: 07 4053 6111
f: 07 4053 6177
e: care@hearingservices.com.au

AUDIOLOGY REQUEST

Name:  DoB:  Phone: 
Auditory Assessments
Audiometry, Speech & Tympanometry
Employment Audiometry

Hearing Aid Assessment
Tinnitus Assessment
Custom Ear Plugs- Water/Noise/ComSet
Electrophysiological Assessments
Auditory Brainstem Response (ABR)
Auditory Steady State Response (ASSR)
Electrochochleography (ECHoG)
Otoacoustic Emissions (OAEs)

Balance Assessments
VNG/Calorics
VEMPs
Static Posturography
VertiTest
Comment:    Date: 
Referrer:  The Patient will make the appointment.
  Please contact the Patient to make an appointment
  An appointment has already been made for the Patient
Referrers Email: 

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Where to find hearing services
Location map

Fees for Service
North Queensland Hearing Services Pty Ltd is a private fee for service audiological practice. Unless other arrangements are inplace, such as an employer paying for a work related hearing assessment, clients are responsible for the payment of accounts at the time the service is rendered. Service fees are not rebatable by Medicare. Certain health care funds will refund on audiological consultations. Most health care funds will rebate on hearing aids if you have appropriate cover.