New Patient Information Packet


Thank for choosing Roseville Diagnostic Hearing Center. We understand that medical information about you and your health is personal. Our team is committed to protecting your health/medical information or protected health information (PHI).

We look forward to meeting you! We are committed to providing the best hearing health care possible. We want to give you the peace of mind that you will receive a thorough diagnostic evaluation performed by a licensed audiologist. We are here to assist you in any way to improve your hearing. If you need any assistance in getting your current hearing aids repaired, we will send your hearing aids to the manufacturer for repair at reasonable cost.

Please take a moment to complete the Patient Registration form, Health Questionnaire Form, Verbal Communication form and bring them with you to your appointment. Forms are available in the office if you are unable to print the forms ahead of time. Please arrive 15 -20 minutes early.

If you have any questions, please contact our office at (916) 780-4200.

Thank you!

Roselynn Gamboa Young, Au.D, CCC-A