Evaluation Request Form

Please use the form below to submit an Evaluation Request to Supportive Hearing Systems.

You will receive a copy of your submission in your email.

Order Information

Soundfield Systems

Personal Amplification - Simeon Voice Over

Personal FM - Comfort Digisystem/Contego

All receivers come standard with headphones. If you would prefer earbuds OR the Simeon 85HE output limiting earphones instead, please indicate this here.

Accessories (optional)

e.g. 2x extra 624 microphones, 2x charging stands, 3x Cable 3.5-RCA, etc.
If you decline to be subscribed will we consider this your answer for all future forms. You do not need to select "no" each time.