Welcome to Hear in the Fox Cities.  We are a 501c3 non profit organization. We provide funding for hearing services such as hearing aids, repairs, ear molds on a sliding fee scale for children up to 21 in Northeastern Wisconsin.

The application must be filled out completely with supporting documents. If the
application is not completed it will not be processed; however, if you have any
questions about how to fill out a section of the application then please email us at hear@hearinthefoxcities.org.

Note, before continuing with this application have either of these documents ready:

If billing the insurance company, please have the estimated itemized invoice ready. Please include product, insurance discount, estimated insurance payment, and estimated patient responsibility.  Or if no insurance, then an itemized quote which projects the total cost of audiology services and product.  

 

Upon acceptance as the hearing aid provider for your patient, you agree to the following terms:

1. Recommend and fit the optimum amplification that is most appropriate for the child seeking funding.

2. Schedule the fitting appointment next available, not to exceed 1 month, to expedite the fitting of hearing aid(s)

3. Fit the patient using best practices including, but not limited to, verification and validation with Real Ear measurements.

4. Provide explanation to the patient's parent(s) and/or guardians the benefits of FM systems and other ALDs as applicable.

5. Return the hearing aid(s) purchased by Hear in the Fox Cities if the patient no longer needs the devices or the patient is not fit.

6. Extend all applicable hearing aid manufacturer warranties, including loss and damage warranties, to the patient. Loss and damage deductibles, office visits/service charges after 1 year of service, hearing aid parts outside of manufacturer warranty, and diagnostic services may apply.

7. Comply with all provisions of federal and state laws and regulations relating to the dispensing of hearing aids.

Hear in the Fox Cities dispensing fee is $600 per ear. Dispensing fee includes 1 year of in-house services rendered including, but not limited to, hearing aid programming, hearing aid clean and checks, earmold services, etc. If Loss & Damage, Deductibles, office visits, or out of warranty repairs are prohibitively expensive patients/audiologists are encouraged to re-apply.

By printing and signing below, I affirm that the information contained in this application is current and complete and I agree to the terms listed above.