Apply for Assistance

If you are interested in participating in our program, please download and bring this form with you to your child’s hearing care appointment.

Who’s eligible?

  • Hear in the Fox Cities provides a sliding-fee scale to those with a financial need.
  • No income limits to apply.
  • Having insurance is not exclusionary; we understand that high deductibles and copays still make the purchase of hearing aids difficult without assistance.
  • Children aged 21 and under in the Fox Cities of Northeastern Wisconsin (northward up to Green Bay).

What can you receive help for?

  • Purchasing of hearing aids
  • Hearing aid repairs and molds
  • Helping find and pay for clinical audiology services (please email or call us directly if this applies to you)

Non-Discrimination Policy

Hear in the Fox Cities does not discriminate on the basis of the following characteristics including, but not limited to race, color, ethnicity, national origin, citizenship status, religion, sex, age, affectional/sexual orientation, gender identity or expression, veteran status, personal appearance, genetic information, political affiliation, familial status, marital status, or disability in any of its policies, procedures or practices. This non-discrimination policy covers membership to our board of directors, committees, volunteers, vendors and our clients.