MESA

(480) 725-2146

SCOTTSDALE

(480) 571-9788

New Patient Forms

New Patient Forms

Please fill in the forms by clicking on the links below. If you have Adobe PDF, you may be able to fill out the forms online. Please print the forms, sign them, and then bring them with you to your appointment.

Patient Form – English

Patient Form – Spanish 


Flexible Financing Available

If you can not afford the full cost of your hearing aids, you may be eligible for financing! Advanced Hearing Group has partnered with CareCredit to bring you flexible financing options you can use toward your next hearing aid purchase.

For more information and to see if you qualify, Click Here.


Referral Form For Your Doctor

Please click the link below to open the form. Print the form and bring to your doctor to fill out.

Patient Referral Form

Mesa Office

480-376-7076
Mon – Fri | 8am – 5pm

North & South Scottsdale Offices

480-608-9817
Mon – Fri | 8am – 6pm

We Accept Most Insurances

Mesa Office - Advanced Hearing Group

South Scottsdale Office - Advanced Hearing Group

North Scottsdale Office - Advanced Hearing Group

Recent News

Understanding Tinnitus: Causes, Symptoms, and Treatment

While tinnitus can be a persistent challenge, understanding its causes and symptoms is a crucial step toward effective management. Whether through lifestyle adjustments, medical interventions, or therapeutic approaches, there are various treatment options available....

Audiology Services For Seniors: Improving Quality of Life

As we age, various aspects of our health require more attention, and hearing is no exception. For older individuals, maintaining good hearing health is essential for a high quality of life. Audiology services for seniors play a significant role in addressing...

The Shocking Truth About Q-Tips: They’re NOT Made For Ear Cleaning!

If you’ve never been told the truth about Q-tips®, you could be in for a real surprise. But first, it’s important to know exactly what we're talking about. When we say ‘Q-tips®’ in this article, we’re referring to ANY device that has cotton swabs on the end with a...

Happy Patients:

We want to thank Dr. Johnson and the staff at the South Scottsdale office, for their prompt service, when I had a problem, with one of my hearing aids. They saw me within an hour of my call to their office and resolved the problem, in a few minutes. We appreciate a business that is so helpful and caring.

Lisa B.

As a person who was just diagnosed with tinnitus and some hearing loss, I decided to see Dr. Gary Johnson and discuss if hearing aids would be beneficial to me. Dr. Johnson gave me a thorough examination and evaluation and recommended hearing aids for me to help with the hearing loss and help quiet the tinnitus. I have been wearing my new hearing aids for about 2 months now and I am so happy with them. Dr. Johnson did a wonderful job evaluating what would work for me. He is very pleasant, listens to the needs of the patient, answers all questions and makes you feel very comfortable. I have been helped with the hearing aids for both my tinnitus and hearing loss. Don’t hesitate to go see Dr. Johnson if you are in need of someone who can help with your tinnitus and hearing problems. He is the best in the business.

Laura S.

I had a hearing aid quit on me. I went into the Mesa location and was greeted by a pleasant young lady and was promptly helped to get my hearing aid working again. And there was no charge !!Great service and pleasant staff. What a great experience !!

Gordon O.

Will health insurance cover my hearing aids? What about ear wax removal?

Insurance covers many hearing & audiology services

Health insurance companies cover a variety of hearing aids. Since there are often specific requirements, and/or limitations on what or how much is covered, it is important to thoroughly understand what your health plan offers. It is our goal to find the type of hearing aid that is most suitable for your hearing loss. We will also help you understand your treatment options as they relate to your health insurance coverage.

Most insurance typically covers the cost of earwax removal services, with the patient paying only their standard policy deductible. However, the cost of earwax removal is not as expensive as you might think – without going through insurance, the cost of a standard earwax removal is $95.00 for either one ear or two.

We proudly contract with the insurance companies listed below. Our list is constantly growing, so check back often to see if your company is included. Alternatively, you can call us for assistance with your plan’s coverage, or to see if we contract with your insurance.

AARP / AARP Medicare Complete / Banner
ACN Connected Care
Aetna / ALL plans/ Banner
Alaska Care
Arizona Care Network (ACN)
Arizona Complete Health (AHCCCS)
Allwell Commerical / AHCCCS
Ambetter
Ameriben
American Postal Workers Union (APWU)
Arizona Health Care Cost Containment (AHCCCS)
Arizona Medical Network (AMN)
AZ Complete Health Care
Banner Health Network PPO,HMO, Medicare
Banner Medicare Advantage Dual (SNP)
Banner University LTC (AHCCCS)
Banner University Family Care (AHCCCS)
Beech Street
Blue Cross Blue Shield / All Plans / Banner
Cigna / All Plans / Banner
CMDP (AHCCCS)
Cofinity
Core Civic
Coventry
First Health
Fortified Provider Network (HMN)
GEHA
Gilsbar
Golden Rule
Great West Health
Health Choice (AHCCCS)
Health Choice Pathway (SNP)
Health Management Network (HMN)
Healthnet (All Plans)
Health Smart
Humana / All Plans / Banner
ICE Health Services (IHS)
Imperial Insurance
Mail Handlers Benefit Plan (MHBP)
Medicare Part B
Medicare Railroad
Magellan Complete Care
Meritus
Mercy Care Advantage (SNP)
Mercy Care Plan (AHCCCS)
Mercy Care Group Health
Mercy Care RBHA
Mercy Maricopa Integrated
Molina Care (AHCCCS)
Molina Medicare Complete Care
Multiplan/RAN
Oscar Healthcare (Cigna only)
OWCP (Workers Comp.)
Refugee Medical Asst. Program (RMAP)
Southwest Services Administrators
Tricare West Region / HNFS
Triwest / VA Community Care
United Food and Commercial Workers (UFCW)
UHC AARP Medicare Complete ( Banner)
UHC Dual Complete (SNP)
UHC Community Plan (AHCCCS)
UMR
United Mine Workers Union (UMWU)
United Healthcare / All Plans / Banner
Wellcare
Washington State Labor of Industry

Mesa Office

480-376-7076
Mon – Fri | 8am – 5pm

North & South Scottsdale Offices

480-608-9817
Mon – Fri | 8am – 6pm

We Accept Most Insurances

Mesa Office - Advanced Hearing Group

South Scottsdale Office - Advanced Hearing Group

North Scottsdale Office - Advanced Hearing Group

Recent News

Understanding Tinnitus: Causes, Symptoms, and Treatment

While tinnitus can be a persistent challenge, understanding its causes and symptoms is a crucial step toward effective management. Whether through lifestyle adjustments, medical interventions, or therapeutic approaches, there are various treatment options available....

Audiology Services For Seniors: Improving Quality of Life

As we age, various aspects of our health require more attention, and hearing is no exception. For older individuals, maintaining good hearing health is essential for a high quality of life. Audiology services for seniors play a significant role in addressing...

The Shocking Truth About Q-Tips: They’re NOT Made For Ear Cleaning!

If you’ve never been told the truth about Q-tips®, you could be in for a real surprise. But first, it’s important to know exactly what we're talking about. When we say ‘Q-tips®’ in this article, we’re referring to ANY device that has cotton swabs on the end with a...

Patient Forms was last modified: November 16th, 2021 by Olivia