If you wish to apply for hearing assistance, please use the form below.  You will need to download it, print it, fill it out, and return it to the address listed on the form.  Don’t forget to include proof of income.

You must be a resident of this area (La Pine, Gilchrist, Sunriver) for a minimum of one year, and you must meet the income requirements (no more than 200% of the current poverty level).  If you’re unsure, apply anyway, and we will let you know.