Become a patient
One of our primary goals is to assist with obtaining hearing aids for lower-income patients living in Northern California. Our hope is that if someone needs and wants to hear better, we will help to make that possible.
There are four basic steps to becoming a patient:
1
SEE IF YOU QUALIFY
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Pacific Hearing Connection provides hearing services to individuals whose household income is no more than 80% of the area median income for Santa Clara County.
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2
FILL OUT OUR APPLICATION BELOW AND SUBMIT YOUR ELIGIBILITY DOCUMENTS​
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Complete the new patient application below. If you would like these forms mailed to you, please contact our office.
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3
WE WILL SCHEDULE AN APPOINTMENT WITH YOU
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Once you have submitted your completed application to our office, we will review it along with your financial documents to see if you qualify. If so, our audiologist will contact you to schedule an appointment.
4
VOLUNTEER 8 HOURS AT THE NONPROFIT OF YOUR CHOICE
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As part of our greatly reduced fees we ask you or a loved one to volunteer 8 hours at the nonprofit of your choice. There is a section of the application that covers volunteer time. This can be discussed with our audiologist at the time of your first appointment.
If you have questions about our program and whether or not you qualify, please read our FAQ or contact our office.
Pacific Hearing Connection complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sexual orientation, or gender identity.