2012 Hearing Professional of the Year

Entering the competition is easy. Simply complete our online application form provided and click the "vote now" button! Or, request a printed application form via the mail from Rayovac Hearing Professional of the Year, 601 Rayovac Drive, Madison WI 53711 or download the application now.

Name:
Address:
E-mail:
I would like to nominate:
Title:
First Name:
Last Name:
Hearing Professional Address:
My Hearing Professional deserves to be Hearing Professional of the Year bacause:
How did you choose your Hearing Care Professional?
Recommended by someone Near my home Advertisement Other
How many times per year do you visit your Hearing Care Professional?
Once Twice Three Times Four or More
How many hours a day do you normally wear your device(s)?
Occasionally 2-5 hours 5-10 hours More than 10 hours
What is your age group?
Under 25 25-45 46-65 66-80 Over 80
What prompted your first visit to your Hearing Professional?
Device service Device purchase Purchase batteries Purchase accessories
What was the reason for your last visit?
Device service Device purchase Purchase batteries Purchase accessories
Yes - I would like you to share my comments with my Hearing Care Professional.
Yes - I would like to receive information on Rayovac hearing aid batteries.