Following
FDA regulations, we ask you to agree to one of the two statements below before purchasing
your hearing aids.
Choose from one of these two statements
1) I have been given a hearing evaluation by a licensed physician and
have received a recommendation for a hearing aid. (Please send recommendation
to HearPod at customerservice@myhearpod.com, or fax to 800 409-5128.)
2) I am hereby advised by HearPod that the Food and Drug Administration
has determined that my health interest would best be served if i had a
medical evaluation by a licensed physician prior to being fit with hearing
device(s).
I understand the FDA regulation and state that I am at least 18 years of age and believe, in my own judgement,
that I am qualified as a candidate for hearing aids. (In accordance with
FDA regulations, your choice will be kept on file by HearPod for three
years from the date of purchase.)
*required
Please review our Privacy Policy. (Print a
copy, if you wish.)
*required
Please enter your full name below, acknowledging your understanding and
agreement to the above:
*required
Thank you! Please continue.
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