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I acknowledge that I am 18 years of age or older and that I have been advised by Hearing Aid Dr that the Food and Drug Administration (FDA) has determined that my best health interest would be served if I had a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) before purchasing a hearing aid. I do not wish a medical evaluation before purchasing a hearing aid.

 

If you have or think you may have any of the following conditions, Hearing Aid Dr advises you to consult promptly with a licensed physician (preferably an ear specialist) prior to purchase:

  • Visible deformity of the ear
  • Drainage from the ear within the past 90 days
  • Sudden, rapidly progressing, or fluctuating hearing loss
  • Acute or chronic vertigo (dizziness)
  • Hearing loss on one side that has worsened in the past 90 days
  • Ear infection, pressure / fullness, blocked ear canal (cerumen or debris)
  • Pain or discomfort in the ear(s)
  • Sudden onset of ringing in the ears within the last 90 days

Hearing Aids:

You are purchasing a hearing aid based upon the information you have submitted to Hearing Aid Dr. Any examination or representation made by an Audiologist or Hearing Aid provider in connection with the practice of dispensing, fitting, or dealing in hearing aids is not a medical examination, diagnosis, or prescription by a person licensed to practice medicine and, therefore, must NOT be regarded as a medical opinion or advice. Hearing aids will NOT restore normal hearing, nor will it prevent further hearing loss. It is also recommended that an Otoscopic examination is performed before the purchase of a hearing aid.

By signing this waiver, you agree that you are the person that will be the end-user and wearer of these hearing aids, and that the reason for purchasing these hearing aids from Hearing Aid Dr is for the sole purpose of personal use only and not for competitive research, resale, or any other reason.

You also agree that you have read, understand, and agree with our “Terms of Service” accessible at www.HearingAidDr.com and that you’ve reviewed a copy of our Bill of Sale outlining the terms of your purchase available at www.HearingAidDr.com.

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