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Refer your patient to Connect Hearing using our online form

Fill out our online form to quickly refer your patient to Connect Hearing. We will reach out to your patient directly to schedule the an appointment based on your request.
Please ensure your patient is aware of the referral to Connect Hearing and expecting to be contacted by us.

Patient's First Name
Patient's Last Name
Patient's Phone Number
Patient's Email
Patient's Postal Code
Service requested
	I confirm the referred patient has consented to be contacted by a Connect Hearing representative about this referral.
Referring Physician's Name
Clinic or Office Name
Physician or Office Email
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*VAC, WCB, WSIB, ADP & ODSP accepted. Part of the WorkSafeBC Provider Network. * Based on national physician referrals over the tenure of the corporation's Canadian business operations compared to the disclosed referral count of leading competitors. **Hearing evaluations/tests are free for all customers over the age of 50. Some conditions and exclusions may apply. See clinic for details

Physicians Resource Centre

Refer your patient to Connect Hearing using our online form