Purchase an Enhanced upgrade (2024)

Purchase an Enhanced upgrade (2024)

Please submit this form to purchase an upgrade to your Healthy Hearing membership. This is a paid feature.

Billing details

An enhanced membership is $90/month or $1080/year.

Your Name*

Practice name*

Street address*

City*

State*

ZIP*

How many locations are part of your practice?*

How many locations are you upgrading to enhanced?*

Each upgraded profile is billed separately.

Are you paying monthly or annually?*

The fee for upgrading each enhanced profile is $90 per month or $1080 per year.

Annually

Profile link(s)

Please copy and paste links to the Healthy Hearing profile(s) you would like upgraded.

**Optional: Consolidated billing through CQ Partners

If you'd like to be billed through your CQ Partners account, please provide your Hcode.

When we receive this form, we will confirm your purchase via email.

Phone number*

Email address*

Send me a copy of my responses

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