Heard It Through The Grapevine Audiology, PC

Taking Care of Ears Throughout the Years

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Dr. Tara Wheeler

Eneida Zavala

Carmen Pustejovsky

Tara Weinberg

Contact Us

817-488-1637

Patient Paperwork

GO GREEN!
Fill out forms on our new
online registration system.

**IMPORTANT **
**Please take a moment to review our new office policies**

Click here if you are a new patient

Click here if you are a returning patient

To fill out the forms online using the online registration system, click on the links below. Please fill out the first four forms and the appropriate case history.

Registration Form

Consent Form

Privacy Policy

Financial & Insurance Policies

Adult Case History

Pediatric Case History 0-5 Years

Pediatric Case History K-12



To download and print the forms, click on the links below:

Registration Form

Consent Form

Privacy Policy

Financial and Insurance Policies

Adult Medical and Hearing History

Pediatric Case History (K-12th grade)

Pediatric Case History (0-4 years)

Heard It Through The Grapevine Audiology, PC
2200 Pool Rd., Suite #102
Grapevine, TX 76051
Phone: 817-488-1637
Fax: 817-488-2854

Hours: Monday 8-5, Tuesday 8-6, Wednesday 8-12, Thursday 8-5, Friday 8-4

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