New Patient Form

New Patient Form New Patient Forms

 New Patient Form

We’d like to welcome you as a new patient at Sound Hearing Audiology and Speech. Be assured you will receive quality treatment for whatever your needs are.

Before you come in for your first appointment, please download, fill out and sign the New Patient Intake Form.

Please bring this completed, signed form, when you come for your first appointment.


Click the button below to download the Patient Intake Form.

Patient Intake Form

Sound Hearing Audiology and Speech – Dr. Robin Zeller, Ph.D.
50 Hazelwood Drive, Jericho NY 11753
Audiologist, Speech Language Pathologist, Speech Therapy, Hearing Aids, Hearing Loss Treatments for Adults and Children