Make a Professional Referral

At Lincoln Hearing Clinic, we welcome referrals from physicians to assist with their patients hearing loss issues.

By Phone

(905) 563-HEAR (4327)

Office Hours

Monday to Thursday: 9am to 4:30pm
Friday: 9am to 3pm
Saturday & Sunday: Closed

Niagara Address

Fleming Building
4413 Ontario St., Suite 103
Beamsville, ON L0R 1B3

By Email

Referring Physician Name: *

Referring Physician Phone: *

Patient First Name: *

Patient Last Name: *

Is this patient: *

A Child

An Adult

Who will we be speaking with about the appointment? *

Patient Directly Parent or Guardian (if Child) Child of Older Patient Other

Contact Person Phone Number: *

Service Required: *

Hearing Assessment

Hearing Aid Needs Evaluation

Hearing Aid Checkup

Other Comments: *

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