Hearing - Soundfair

About you

We will use this information to remind you when it’s time for your next appointment or check-up. Find out if you need to do anything for your hearing next.
First Name*
Last Name
Email*
example@example.com
Mobile Phone Number
We will only ever SMS you reminders.
Postcode*

It takes only a couple of minutes, and could save your hearing!
Have you ever completed a hearing test?*

YesNo
When did you have your last hearing test?

DayMonthYear
If you can't remember, an approximate date is fine!
Date of Birth*

DayMonthYear
Screening is recommended to those within the age group.
Gender at birth*

FemaleMale
Todays date

DayMonthYear
Age
Last Hearing Test
Last Hearing Test days
Days until next test is due over 40s
Days until next test is due over 50s
Last Screening Score
If 1000, they are due for screening. They are of age and haven't done one for 5 years, or have never done one.
dueDate

YearMonthDay
Date

About you