Cochlear Implant Case History Form

Individuals who already have a CI and are transferring services to the University of Nebraska-Lincoln, or those who have never seen us before, should fill out the Cochlear Implant Case History Form (PDF).

Adult Intake Packet

Adults who are interested in going through the CI candidacy process should fill out the Adult Intake Packet (PDF).

Pediatric Intake Packet

Parents who are interested in having their child go through the CI candidacy process should fill out the Pediatric Intake Packet (PDF).