• New Patients
  • Billing
  • Directions

New Patients

Info for New Patients

If this is your first visit please be sure to bring with you the following information:

  • List of medications
  • List of past surgeries (including date of your surgery) and medical problems
  • Insurance card
  • Any referral from your physician

Please arrive 15 minutes early for the appointment.
Please fill out our questionnaire & necessary paperwork before you come in.

Please click on the Adult Form or Child Form.

Adult FormAdult Form Child FormChild Form

 

Please click on the Release Form below. Submit the completed form to your doctor a few days prior to your appointment.

Authorization to Release FormRelease Form

Billing

We accept payment by cash, check, debit or credit card. Major credit cards and insurance companies are accepted. Please note that we don’t submit a claim to insurance companies for CAPD evaluation and treatments as well as sound retraining therapy.

We recommend that patients contact their insurance company to verify their benefits for hearing evaluations prior to their appointment.

We are happy to bill your insurance for hearing evaluation. If correct information is not provided at time of service, you will be responsible for all charges as billed and an additional $25 rebilling fee.

Some insurance companies have a benefit towards the purchase of your hearing aids. We will assist you in determining a benefit that can assist with the cost of the instruments.

Finance Options


FundMyDr.com We offer finance options through FundMyDr.com. Applying for a medical loan with FundMyDr.com is fast and easy. We allow you to apply through our secure online system @FundMyDr.com or over the telephone. FundMyDr.com offers a variety of convenient financing programs with flexible payment options and convenient monthly payments. We take the worry and hassle out of the application process

  • All loans have NO pre payment penalties
  • Installment plan options with FIXED interest rates
  • Finance Programs up to 60 months, with monthly payments starting at $60 a month
  • Interest free programs up to 24 months
  • Financing up to $30,000
  • Financing available for patients with less than perfect credit


BELLEVUE OFFICE Office Image


  • 1370 116th Ave. NE Suite 201
         Bellevue, Washington 98004
  •   425-455-0526
  •   425-818-9509
  •   info@pacaudiology.com
  •   Hours: Mon-Fri 10am-5pm

Directions to Bellevue clinic

I-405 Northbound:
Take the NE 4th St. exit eastbound. Turn left at the first light(116th. Ave. NE). Stay on this road for 1 mile. Turn right into the driveway located in front of the Eastview Building sign. Drive to the building in the back lot.

I-405 Southbound:
Take the NE 8th St. exit eastbound. Turn left at the first light(116th. Ave. NE). Stay on this road for 1/2 mile. Turn right into the driveway located in front of the Eastview Building sign. Drive to the building in the back lot.

Parking is available free of charge.

Map


View Larger Map

Billing

We accept payment by cash, check, debit or credit card. Major credit cards and insurance companies are accepted. Please note that we don’t submit a claim to insurance companies for CAPD evaluation and treatments as well as sound retraining therapy.

We recommend that patients contact their insurance company to verify their benefits for hearing evaluations prior to their appointment.

We are happy to bill your insurance for hearing evaluation. If correct information is not provided at time of service, you will be responsible for all charges as billed and an additional $25 rebilling fee.

Some insurance companies have a benefit towards the purchase of your hearing aids. We will assist you in determining a benefit that can assist with the cost of the instruments.

Finance Options


FundMyDr.com We offer finance options through FundMyDr.com. Applying for a medical loan with FundMyDr.com is fast and easy. We allow you to apply through our secure online system @FundMyDr.com or over the telephone. FundMyDr.com offers a variety of convenient financing programs with flexible payment options and convenient monthly payments. We take the worry and hassle out of the application process

  • All loans have NO pre payment penalties
  • Installment plan options with FIXED interest rates
  • Finance Programs up to 60 months, with monthly payments starting at $60 a month
  • Interest free programs up to 24 months
  • Financing up to $30,000
  • Financing available for patients with less than perfect credit

BELLEVUE OFFICE Office Image


  • 1370 116th Ave. NE Suite 201
         Bellevue, Washington 98004
  •   425-455-0526
  •   425-818-9509
  •   info@pacaudiology.com
  •   Hours: Mon-Fri 10am-5pm

Directions to Bellevue clinic

I-405 Northbound:
Take the NE 4th St. exit eastbound. Turn left at the first light(116th. Ave. NE). Stay on this road for 1 mile. Turn right into the driveway located in front of the Eastview Building sign. Drive to the building in the back lot.

I-405 Southbound:
Take the NE 8th St. exit eastbound. Turn left at the first light(116th. Ave. NE). Stay on this road for 1/2 mile. Turn right into the driveway located in front of the Eastview Building sign. Drive to the building in the back lot.

Parking is available free of charge.

Map


View Larger Map