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Your Element
™
Hearing Instruments
Hearing Healthcare Professional:__________________________
_____________________________________________________
Telephone: ____________________________________________
Model: _______________________________________________
Serial Number:_________________________________________
Replacement Batteries: Size 13 Size 10
Warranty: _____________________________________________
Use Automatic Program for (if applicable)
1: Quiet
2: Group/Party Noise
Use Manual Program 1 for: ______________________________
Use Manual Program 2 for: ______________________________
Use Manual Program 3 for: ______________________________
Date of Purchase: ______________________________________