Audiology

Office: (361) 694-5678
Fax: (361) 694-4821

Fax information required by referring physician:

• DCH patient referral form or physician’s order including physician’s signature
  • Evaluation and/or treatment specified
  • Diagnosis, including ICD-10, supporting requested services
• Physician’s notes or H&P supporting requested services
• Insurance / Medicaid card (front and back)

Patient must bring to appointment:

• List of current medications
• Patient must be accompanied by parent/guardian (with ID for verification)
• Insurance/Medicaid card