GP Referral Forms

Refer Your Patient to Harmony Hearing

Harmony Hearing understands that as a doctor, you want the best treatment and outcome for your patients. Harmony Hearing is also committed to ensuring the best hearing outcomes for our clients.

We value all referrals and our relationships with other health professionals, and will provide each referring doctor with a report advising of the outcome of each appointment or treatment provided. Simply use the downloadable PDF or online form to refer your patients with hearing difficulties to us.

Patient Information:

Name(Required)
Address(Required)

Please provide the following hearing services:

Audiological Assessments
Hearing aid services
Specialised Services
Hearing protection
Are there medical contraindications to the fitting of a hearing device?(Required)

Referring Doctor:

You can print and/or email the above PDF referral form to [email protected], use your preferred secure messaging system or give it to your patient to bring along with them to their appointment with us.