Book an Appointment
For Your Appointment
To schedule an appointment: Call us at 207-874-1065. Please have the following information available:
- Insurance information. Have your insurance card with you when you speak with us and bring it along with your photo ID to your appointments
- Primary Care Physician and Referring Specialist information
- Patient name, date of birth, address, phone number, etc.
- Reason for appointment (i.e., concerns, etc.)
- Patient availability for scheduling
For your convenience and to expedite the check-in process, please print and complete the following forms prior to your first appointment at Northeast Hearing & Speech.
(You will need Adobe Acrobat Reader to download and print these forms. Click here to download)
For a link to fillable forms that are automatically submitted, please contact us at 207.874.1065 or email us at: [email protected].
Audiology Clients
Adults (18+)
Children (Birth-18)
Speech-Language Clients
Adults (18+)
Children (Birth-18)
- Client Data Sheet
- Case History Form (for children ages 5 or younger)
- Case History Form (for school-aged children)
- HIPAA Summary and/or HIPAA Long Form