Request an Information Pack!

In addressing your hearing loss - or that of a family member or friend - it can be hard to know where to start. 

If you complete the form below, we will send you our informative DVD, a complimentary pen (valued at $25), and a stylish fold-up shopping bag!

 

The Information Pack also covers: -

• How can assess whether hearing loss is having an impact on my life?
• Facts about hearing loss.
• Answers to common questions about hearing loss.
• Modern hearing technology.
• How to help friends and family address their hearing loss.

 

* Indicates required fields

First Name*:

Last Name*:

Address*:

Suburb*:

State*: ACT NSW NT QLD SA TAS VIC WA

Postcode*:

Phone:

Email:

Age: Under 21 21-35 36-50 51-64 65+

Do you comply with the Australian Government Hearing Services Program?: Yes  No  Don't know 

Are you seeking the Information Pack on behalf of a family member or friend you suspect may have a hearing loss?: Yes  No 

Are you happy for HearingLife to contact you via post or phone in the future?: Yes  No