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    Kristine L. Jarrell Owner, AudiologistSierra Tibbetts AudiologistLisa Sanchez Board-Certified Hearing Instrument SpecialistAleayah Thayer Audiology TechnicianDeanna Ellefson Balance TechnicianJustine Hall Patient Care Coordinator
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        20 NW Birch St
        Coupeville, WA 98239
        (360) 678-1423
        (360) 678-1769
        Mon: 9:00am – 5:00pm Tue: 9:00am – 5:00pm Wed: 9:00am – 5:00pm Thu: 9:00am – 5:00pm Fri: 9:00am – 12:00pm
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Patient Forms

January 6, 2022

New Patients

New Patient IntakeDownload
Acknowledgement of Privacy PracticeDownload
Hearing Care HistoryDownload
Tinnitus Handicap InventoryDownload

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Existing Patient IntakeDownload
Acknowledgement of Privacy PracticeDownload

Balance Neurovestibular Testing

New Patient IntakeDownload
Patient Neurodiagnostic IntakeDownload
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Balance Appointment Day InstructionsDownload
Acknowledgement of Privacy PracticeDownload
Welcome FormDownload

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  • Location

    20 NW Birch St
    Coupeville, WA 98239
    (360) 678-1423 (360) 678-1769
    Mon: 9:00am – 5:00pm Tue: 9:00am – 5:00pm Wed: 9:00am – 5:00pm Thu: 9:00am – 5:00pm Fri: 9:00am – 12:00pm

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