Transcription of Hearing Aid Battery Order Form - ACC
1 Hearing Aid Battery Order form Please keep this Order form in a safe place until you require your supply of new batteries Hearing Aid Battery Order Options You can re- Order your batteries by 1. Going to the internet website 2. Or complete the return slip below If you choose to use the return slip below, please post the completed slip at least 1 month before your current Battery supply has run out, using the freepost details below. Freepost 225409 ACC Battery Request PO Box 62253 Sylvia Park AUCKLAND 1644 3. Or reorder, change, cancel, or reduce your batteries by phoning CommunityClient direct on 0508 222 546 For any other questions about your Battery Order or more information about your Hearing loss claim contact the ACC Hearing Loss team on 0800 101 996.. Hearing Aid Battery form Name ACC Claim Number Date of Birth Current Address Phone Number I confirm the batteries supplied will be used exclusively for an ACC approved Hearing Aid Signature Date Please note that this form is sent to an ACC approved distribution company, who distributes batteries on behalf of ACC.
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