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Ear Exam

HealthChoice Utah Starkey

Step 1: Ship to Information

Step 2: Patient Information

Audiometric Information

(required)

Hz:

R

L

Faceplate Color

Options

Model Starkey Evolv Ai 1000 rechargeable

CIC Non Rechargeable (10)

ITC Non Rechargeable (312)

Model

Half Shell Rechargeable

Model
Model

Full Shell Rechargeable

Model

Evolv Ai 1000 RIC Rechargeable

RIC color options

L
R

Fitting Level

Receiver Gain

Receiver length (for RIC models only)

L
R
L
R

Each new hearing aid comes with a 3-year warranty that covers loss, damage and repair. Loss and damage warranty may require a $300 deductible out of pocket for replacement or if damaged beyond repair. All repair/replacement will be done at the fitting clinic and charges will be paid directly at the clinic. Please call (435) 239-8860 with any questions. For additional questions please email orders@insurancehearingaids.org

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