5 N Maple Avenue, Suite 100, La Plata, Maryland 20646
410-696-3669 ph
410-695-3769 fax
Forms & Other Information
Save time! Complete paperwork before your appointment!
For patients scheduled for a Comprehensive Balance Evaluation:
Click here for a complete packet of pre-appointment paperwork.
For patients scheduled for a Comprehensive Hearing Evaluation:
Click here for a complete packet of pre-appointment paperwork.
For pediatric patients scheduled for a Comprehensive Evaluation:
Click here for a complete packet of pre-appointment paperwork.
Find individual forms below
For everyone:
For adult patients:
For pediatric patients:
Peds Dizziness Questionnaire
Frequently Asked Questions and Helpful Links
What is a Comprehensive Hearing Evaluation?
A comprehensive hearing evaluation is a thorough hearing test. At Rocket Hearing & Balance, we test the entire ear. That includes otoscopy, middle ear testing, and nerve testing. In addition to listening for tones, our patients also participate in different types of speech testing, which provides the most realistic data in regards to communication difficulties.
For more information on our philosophy of hearing care, visit our Hearing Services page.
What is a Comprehensive Balance Evaluation?
A comprehensive balance evaluation is a thorough test of the vestibular system. At Rocket Hearing & Balance, we test the entire system, which includes eye, ear, and body testing. Depending on a patient's history and experience with dizziness, other brain testing may be recommended and performed. We believe that complete, in-depth testing is necessary to properly care for individuals with dizziness and imbalance.
For more information on our philosophy of hearing care, visit our Balance Services page.
How can I prepare my child for an appointment?
At Rocket Hearing & Balance, our patients' comfort is a top priority. When working with children, we remain flexible and "test at the child's speed". Sometimes, more than one visit may be necessary to gather information regarding your child's hearing and/or balance ability--and that's okay!
For specific questions or concerns, please feel free to call our office and speak directly with our professionals.
Do I need to get a referral before my appointment?
Depending on your health insurance, you may or may not be required to obtain a referral prior to your appointment. For Medicare patients, a referral is always required, regardless of the type of any secondary insurance. To make it easier for you and your referring physician, we are happy to accept referrals by fax.
For specific questions or concerns, contact your insurance carrier.