Proudly Supporting Australia’s Hearing Health since 1946

Hearing Access Program Application

Hearing Access Program Application

Use this form to submit an online application for the BHA Hearing Access Program.

You can also download a hardcopy application form here.

  • Patient Details

  • Recommender Details (if applicable)

  • Clinical Details/Notes/Candidate History

  • Fitting Requested

  • Eligibility

  • This field is for validation purposes and should be left unchanged.

Help us help the one in six Australians suffering from the world's most prevalent sensory disability