Online application 2020-02-11T14:28:26+00:00

ONLINE APPLICATION FORM

Take the first step towards a better hearing

    State*

    Approximately in which year were you last employed in a noisy job?

    Heave you previously made a claim for industrial hearing loss?
    YesNo

    If yes, in which year?

    Have you previously received hearing aids? YesNo

    Code:
    (Located in the bottom right corner of the letter)