How Can We Support You?

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* 1. How are you currently feeling about your situation as we begin the lockdown for Covid-19?

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* 2. Do you have support?

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* 3. We have redirected our services toward supporting our community during this crisis. Would you like a member of our team to contact you? If yes, please provide your email and/or phone number below.

Name

Email Address

Phone Number

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* 4. Do you, or one of your household members, have a hearing loss?

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* 5. If yes, how are you coping with your hearing loss at home? Would you like us to send you some handy tips to share with your household on hearing loss aware communication in the home? If so, please provide your email address.

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* 6. Are there hearing related services you are concerned you won't be able to receive during the lockdown?

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* 7. NFDHH has hearing aid batteries that are available for purchase, please provide your contact phone number, email address if you would like us to get in touch about ordering these. Sizes available are: 312, 310 and 675.

Name

Email Address

Phone Number

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* 8. Do you have any other requests or concerns we could help you with? Please let us know in the box below.