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Brentwood, CA925-203-9144

Walnut Creek, CA925-203-9134

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Brentwood and Walnut Creek, CA
925-203-9134

Contra Costa Hearing Aid Center
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    • Brentwood, CA
    • Walnut Creek, CA

Client Intake Forms

New Client Forms

Please complete all three of these forms below before your appointment.

  1. Client Intake Form & Case History
  2. HIPAA Notice of Privacy Practice
  3. Characteristics of Amplification Tool (COAT)

Contra Costa Hearing Aid Center

Brentwood, CA

1240 Central Boulevard, Suite A2
Brentwood, CA 94513

Call or Text: 925-203-9144

Monday - Thursday, 9am-4pm
Friday, 9am-2pm

Walnut Creek, CA

1196 Boulevard Way, Suite 1
Walnut Creek, CA 94595

Call or Text: 925-203-9134

Monday - Thursday, 9am-4pm
Friday, 9am-2pm

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Last reviewed in Oct 2022.

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