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Become a patient

One of our primary goals is to assist with obtaining hearing aids for low-income patients living in Northern California. Our hope is that if someone needs and wants to hear better, we will help to make that possible.

There are four basic steps to becoming a patient:


Pacific Hearing Connection provides hearing services to low-income individuals whose household income is no more than 400% of the Assistance Income Guidlines.

See eligibility guidelines >




Complete the new patient application below. If you would like these forms mailed to you, please contact our office.



Our volunteer service program allows us to thank our community for supporting us and making it possible to offer reduced fees. Please be willing to complete volunteer hours, if applicable.



Once you have submitted your completed application to our office, we will review it and contact you to schedule an appointment.

If you have questions about our program and whether or not you qualify, please read our FAQ or contact our office.


Pacific Hearing Connection complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sexual orientation, or gender identity.

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