Custom Ear Plug Appointment Request

 

Complete the following form to request a custom ear plug impression appointment.  Please note that a completed form does not constitute a booked appointment.  A Health Conservation Consultants representative will be in touch with you via the contact information provided to finalize all appointment details.  You can also phone to book your appointment by calling: 1-877-920-TEST(8378)

 

NOTES: 

  • Piercings in or on your ears may need to be removed during the molding process.
  • Currently, appointments for custom molds are only availabe in our Edmonton facility.
    Mobile testing is available for groups in other locations.

Client Information

 

Appointment Information

  • Appointments should be scheduled between 8:00am and 4:30pm, Monday - Friday. After-hours testing may be available for groups of 5 or greater. Please call us if this applies to your situation.
 

Custom Plug Type

 

Customization Options

 

Verification