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Home
Autism
About Altogether Autism
Journal
Community
Community Programmes
Maori Disability Support
Multi-Sensory Environments
Ngā Mara Ātea – A Marae Centred Programme
Positive Action Course – Hamilton
Transition Programme – from school to adult life
Disability Support
Needs Assessment Service Coordination (NASC)
Contact us
Living my Life
Local Area Coordination (LAC)
What we do
Stories
My Life My Way
Equipment Centre
Hearing
About Hearing Therapy
Find a clinic, book an appointment
Find a clinic location, time and date
Register Online
Health Professionals
Referral Form for Professionals
News and Articles
Resources
Communication Tips
Online Hearing Test
Presentations
Hearing Aids
Newsletter
Posters and resources for download
Training
EMS Accreditation Online Learning Module
New Zealand Diploma in Hearing Therapy Level 6
Useful Links
What our Clients Say
Information
Disability information and advice
Disability Start workshops
INFOLINK E-Newsletter
Online Information Hub
Personalised Information
Question Time Videos
News
Check out the latest news
Communications’ Enquiries
Events
Life in a Pandemic
Profiles and E-Book
About
About us
Annual Reports
Contact Details
Daily Living Aids and Equipment
Disabled Leadership Group
Governance
Help us get it right
Senior Leadership Team
Useful Links
Vacancies at Life Unlimited
Vision, Mission and Values
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About Hearing Therapy
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Request a hearing therapy appointment
Request a hearing therapy appointment
Contact details
Name
*
First names
Last name
Address
*
Street Address
Address Line 2
City
Region
*
Choose the region
Northland
Auckland
Waikato
Bay of Plenty
Gisborne
Taranaki
Hawkes Bay
Whanganui - Manawatu
Wellington
Marlborough
Nelson - Tasman
Canterbury
West Coast
Otago
Southland
Contact phone number
*
Other phone number
Email
*
How would you prefer us to contact you with your booking details?
*
Email
Phone call
Other details
Date of birth
*
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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24
25
26
27
28
29
30
31
Month
1
2
3
4
5
6
7
8
9
10
11
12
Year
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
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1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
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1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
(We require your date of birth to enter in our booking system)
Ethnicity
*
Select ethnicity
NZ Maori
NZ European
Other European
Tongan
Samoan
Fijian
Other Pacific Island
Chinese
Indian
Other Asian
African
Other
To help us assist with your appointment, please choose from the following options:
*
Select an option
Reduced hearing/decline in hearing/hearing evaluation
Tinnitus
Dizziness or imbalance
Require additional equipment/information and advice hearing aids and funding and management advice?
Assistive devices such as: fire and safety alerting systems, extra loud alarms, telephones, baby monitors and doorbell alerts
Cochlear implant information and management
Hearing aid management
Improved communication
Have you had a hearing test before?
*
Yes
No
Don't know
How did you find out about Life Unlimited Hearing Therapy
*
Word of mouth e.g. a friend or health professional
Newspaper advertising
Other advertising e.g. radio, magazine, flyer
Google search or internet
Other
Any other comments?
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Hard of Hearing? Hearing Care For All.
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