Refer a Friend

If you have a friend or loved one that needs our help, and they purchase hearing aid(s), we offer one of the following rewards:

• FREE one year supply of hearing aid batteries
• FREE $50 gas card

Just fill out the form below and, if your friend purchases hearing aid(s), you will receive your selected reward.

Your Friend

Name: Address:

Phone: Email:

You

Name: Address:

Phone: Email:

Additional Information

Select your reward: Please select an option... FREE one year supply of hearing aid batteries FREE $50 gas card How would you like to receive your reward? Please select an option... Email Phone call Postal Service

How did you hear about us? Please select an option... Searching the Web Link from another Website Friend Television Radio Questions or comments:

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