Hearing Test and Aid Record

Who this is for

One sheet for hearing tests and the equipment that follows them. The first table logs each test with what you were told, the second holds the make, model and serial number of each aid, and the third records batteries, charging, repairs and servicing as they happen.

Anyone wearing hearing aids or waiting for them, people who have been tested in more than one place, relatives and carers managing somebody else's aids, and anybody asked for a serial number by a repair desk.

What this helps you track

• Each test with the date, where it was done and who did it
• What you were told at the test, in the words you were given
• Make, model, serial number and date supplied for each aid
• Battery type or charging arrangement, written down once and findable
• Repairs, retubing, servicing and replacements with dates and costs

How to use it

1. Fill in your details, the clinic or practice and the supplier at the top.
2. Log each test as it happens, and write what you were told in the words it was said in.
3. Copy the make, model and serial number from the aid itself or its paperwork, one line per side.
4. Note the battery type or the charging arrangement for each aid, exactly as written on the box or by the supplier.
5. Record every repair, retube, service and replacement with the date, where it went and what it cost.
6. Keep the sheet with the receipts and warranty paperwork, or fill it in online and save it in your own browser.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Does the sheet interpret my test results?

No. There is no chart, no range and no explanation on it. The results column is for what you were told by the person who tested you, written down as you were told it.

Why record serial numbers?

Because a repair, a warranty claim, an insurance claim or a replacement all start with the serial number, and it is printed somewhere small on a device that is easy to lose.

What goes in the battery column?

Whatever your aid takes or however it charges, copied from the packet or from what the supplier told you. The sheet names no battery type and suggests nothing about how long one lasts.

Can one sheet cover two aids?

Yes. The aids table has a side column, so left and right sit on their own lines with their own serial numbers, and the servicing table can refer to either.