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Apply for Hearing Aid Assistance

Please start by using the Household Income Calculator below to determine if you may qualify for our services.

Household Income Calculator

If you may qualify, please fill out the online form below or download and print the form to fill out and submit to us.

You can submit your completed application by email, mail, fax, or bring it directly to our office. If you have any further questions or need help completing an application, please contact our office. We will be happy to assist you.

John A. Hinkle
Executive Director & Foundation Board Member
1619 E. Broadway Ave Maryville, TN 37804
Phone: (865) 977-0981 / Fax: (865) 977-5444 / Email:

Online Application

Please read entirely before filling out the application!!!

The mission of the Hearing and Speech Foundation (HSF) is to empower financially challenged individuals with hearing and communication deficits to live their lives to the fullest. We accomplish our mission through the following ways: hearing aid financial assistance, research in auditory and speech perception, and hearing aid recycling. All hearing services from the Foundation are available to you, regardless of the challenging financial situation you may be experiencing. Too many people assume that their disadvantaged financial predicament prevents them from seeking and obtaining hearing aids. With the help of the Hearing & Speech Foundation, the joyful ability to hear and connect with the people around you can become a reality.

Hearing Aid Assistance
The Foundation provides hearing aids and hearing services, including hearing tests and customized ear molds or domes. All of the aids provided by the Foundation are behind-the-ear hearing aids. The type of hearing aids selected for you is determined only by our licensed audiologist. The hearing aids we have available may be new or manufacturer refurbished. Other hearing aids donated through our Recycling Program may be available and will be thoroughly evaluated and reset to match your hearing loss. All earmolds or ear domes are made or sized specifically for your ears.

The administering of the hearing test, the making of earmold impressions, and the final placement of the hearing aids typically take two sessions. At this time the aids become your property and financial responsibility. However, the HSF will provide two (2) free follow-up visits during the first year for minor adjustments, if needed.

Eligibility for our programs is determined by household income and extenuating personal and financial circumstances. We use the U.S. Department of Health and Human Services Federal Income Guidelines to determine client eligibility and fees for services. We accept clients whose gross annual household income follows the chart on the following page. Fee payment is required at the time of service. Using a credit card will result in an additional $10 processing fee.

A copy of the following documentation must be included with your completed application. Failure to do so will result in a delay in processing your application:

  • A completed application for assistance (download and fill out or fill out online below)
  • Verification of residency You may submit a utility, cable or phone bill or a copy of your driver’s license if the address is correct. (Must be a street address, no post office boxes)
  • Proof of household incomeLatest IRS 1040 tax return form and you may be asked to submit a Social Security statement (and/or SSI), an alimony statement, VA benefits statement, retirement pension statement, retirement investment statement, disability income statement, or a check stub from your employer.