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Hearing Instruments
Hearing Healthcare Professional: _________________________
_____________________________________________________
Telephone: ___________________________________________
Model:_______________________________________________
Serial Number: ________________________________________
Replacement Batteries: Size 13
Warranty: ____________________________________________
Program 1 is the Automatic Program
Program 2 is the Manual Program for: _____________________
Program 3 is the Manual Program for: _____________________
Program 4 is the Manual Program for: _____________________
Date of Purchase:______________________________________