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Forms:
(Not available for download anymore)

What is AIT? This PDF Powerpoint will answer your questions!

Preliminary Forms for AIT
Intake Interview - to be submitted 2 weeks prior to training
Informed Consent Form - to be submitted with Intake Interview form (2 weeks prior to training)
Audiogram Information
Social Story - designed to be read with your child prior to AIT

Additional Forms:
Photo/Video Release Form
Testimonial

Insurance Information: While EARS does not file insurance claims, our services could be covered by some insurance providers. We are willing to provide you with an invoice with the service codes, which you can submit to your insurance provider. If you have an MSA or HSA which is a pre-tax medical/health savings account, you can use that to pay for your child’s AIT.

For most forms in Microsoft Word format, please use these links:
Intake Interview
Informed Consent Form
Audiogram Information
Testimonial

(some forms are not available as Word files for legal protection)

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