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ABOUT
HEARING LOSS
HEARING EVALUATION
PRODUCTS
SERVICES
LOCATIONS
- Clinics
- Employment Opportunities
RESOURCES

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First Name *

Last Name *

Email *

Contact Phone Number *

Full Address *

Alternate Phone Number

Contact Method *

Is the appointment for an Adult or Child?

Adult

Child (age 1-18. Note: A consultation fee will be charged at time of appointment )

Child 's Name *

Child's Date of birth *

Relationship to the Child?

Parent

Guardian

Preferred appointment time *

Morning

Afternoon

Evening (select locations only)

At which location would you like to make your appointment? *

No Preference

11 - 1960 Appleby Line, Burlington, ON View address and map

Main Floor 2951 Walkers Line, Burlington North, ON View address and map

104 - 83 Dawson Road, Guelph, ON View address and map

M6 - 414 Victoria Avenue North, Hamilton, ON View address and map

102 - 817 Bayridge Drive, Kingston, ON View address and map

325 Lakeshore Rd. E., Mississauga, ON View address and map

203 - 627 Lyons Lane, Oakville, ON View address and map

1A - 35 Upper Centennial Parkway, Stoney Creek, ON View address and map

#29-250 Wincott Dr. Etobicoke, ON View address and map

3443 King Str. Vineland, ON View address and map

9 - 245 Dundas St. E., Waterdown, ON View address and map

109 - 555 Prince Charles Dr. N. Welland, ON View address and map

What Is the appointment for?

( A fee will apply for certain appointments )

Employment

School/Training

RCMP/Police

Aviation Medical

Hearing assessment

Other

Briefly describe what is the appointment for

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