Product Guidance Questionnaire

The form on this page is designed to help us to offer you accurate and comprehensive guidance on which products will work best with your specific brand and model of hearing instruments, and offer you the best experience based on your specific needs.

If you fill in the short questionnaire below and submit it to us we will come back with a tailored package of products ensuring compatibility with whatever equipment is currently in use – sound advice broken down into individual products, costs, links to product descriptions etc.

Please fill in all boxes as completely as possible, all boxes MUST have an entry. If you have no information to supply please mark N/A.


Click here for guidance on completion of this form
HEARING INSTRUMENT BRAND AND MODEL – We need the brand and model of hearing aids to be able to advise. If a typical ‘behind the ear‘ NHS hearing aid this critical information is usually printed on the spine of the hearing aids, the part that touches the ear when worn. Serial numbers are also often printed on the spine or underneath the battery door. With privately purchased ‘in the ear‘ hearing aids we always need the serial numbers, they tend to be printed on the shell. BAHA’s and cochlear implants you may need to liaise with the implant centre to confirm specific details.

TELEPHONY USE – Telephony should ideally be be a corded handset or headset with very typical RJ9 / RJ11 type connector on curly cord, like this image. Also fine is USB Headset telephony (like Zoom / Teams). Anything else (ie cordless handset or headset, different type of connection) we need to investigate for an alternative solution – please let us know!

PC SOFTWARE – If you want to use PC software with Roger (eg Dragon, Texthelp, ClaroRead, JAWS), and particularly at the same time as answering telephone calls, we need to know in detail the full situation. Please give as much detail as you can in the ‘Additional Info’ box.

MOBILE PHONE CONNECTIVITY – Included as standard with Roger Select is bluetooth mobile phone connectivity. Also in the box with Roger transmitters you are supplied with a short cable that allows a cabled connection from mobile to the transmitter (Roger On and Roger Select) as per this video. (Fast forward the video to 6m 30 secs). We favour the cabled connection which is a more robust connection, is better audio quality than bluetooth and streams ALL audio including music as well as voice calls.


Once you have completed and submitted this form we can analyse the content and respond either with a comprehensive email or an official quotation, you can let us know how you would like that information delivered to you by selecting the last option on the form below.

N.B. For a run down of some of the technology available, how it works and how it fits together, have a read of this page.

Please note – if using Microsoft Edge browser and having problems with this form please try Chrome or Firefox, a recent update seems to be causing some short term problems.

For the last three options above in particular marked ** please describe the situation in fine detail in the 'Additional Info' box
Phonak Roger equipment is almost always supplied with an on site setup and training package
*Additional Roger Neckloop required when using Caption.ed with Roger equipment.
N.B. This form collects personal details so we can give you best advice. Please check out our Privacy Policy to see how we protect and manage your details.

N.B. Having any problems submitting the above form?
Occasionally you might see an error like for instance ‘Submission rejection, token invalid’. There are some easy quick fixes, the first one is the quickest and easiest!

  1. The easiest thing to try is to bypass the cache on the page, on a PC press CTRL and F5. If on a Mac press Command and R.
  2. If that doesn’t work you can clear the cache on your browser (quite easy) or hop on to another browser, eg if you are on Chrome, try Firefox or Internet Explorer.
  3. You can click this link for a plain text version of the information we need to be able to offer the best advice. Just copy the text and paste it into the body of an email, put your answers into the email and send it across to us at [email protected].

Also here is an offline PDF hard copy of the questionnaire if you need that.

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