Hear Again Citrus - Citrus Hearing Impaired Program Services

Two hearing aids beside their charging case on a table

Hear Again Citrus provides hearing-aid assistance to qualifying full-time Citrus County residents who cannot afford hearing aids. Complete the secure online application below and upload all required documents. If you have questions about the program, need help completing the application, or would like to support the program, contact Executive Director Maureen Tambasco at [email protected] or 352-795-5000.

For eligible Citrus County residents

Free Hearing Screenings

Never worn a hearing aid?

Free screenings are available for Citrus County residents who have not been fitted with hearing aids or have not had a hearing evaluation from a hearing aid provider or audiologist.

Are you having difficulty hearing certain sounds?
Do conversations frustrate you and require extra effort to understand?
Are you asking people to repeat information more frequently?

Hearing loss can affect everyone. It can be caused by loud noise exposure and illness, as well as the natural aging process. Citrus Hearing Impaired Program Services (C.H.I.P.S.) offers free hearing screenings at the old train depot property at 109 NE Crystal Street, Suite B, Crystal River, FL. Look for the green, beige, and red striped train cars.

Screenings are by appointment only.
Please call 352-795-5000 to schedule your appointment.

Information about hearing aid assistance is also available below.

Hearing Aid Assistance Application

Applications are reviewed based on need and only after all required information and documents are received. Applicants must be full-time Citrus County residents. If insurance, Medicaid, or Medicare covers hearing aids, the applicant may not qualify for this program.

Fields marked * are required.

Applicant Information

First name Middle name Last name

Date of birth Gender * Marital status *

Permanent address Mailing address

Home phone Cell phone Email address

Household Information Number of people in the household

List up to three dependents.

Dependent 1 name Age

Dependent 2 name Age

Dependent 3 name Age

Employment

Employed Retired Other

Current employer Employer phone Length of employment

Income

List monthly or annual gross income for the applicant and spouse or other household members. Proof of all income is required.

Applicant income 1 source Gross amount Period

Applicant income 2 source Gross amount Period

Spouse or other income 1 source Gross amount Period

Spouse or other income 2 source Gross amount Period

Insurance

Do you have health insurance, Medicaid, or Medicare? * Yes No

If yes, describe any hearing-aid benefit and its amount.

Required Documents

Upload PDF, JPG, or PNG files. Each file may be up to 8 MB, with a combined maximum of 15 MB.

Three months of current income statements * Three months of current checking and savings statements * Valid driver's license or state ID * Insurance hearing-aid benefit documentation, if applicable

Medical Clearance or Waiver

Choose one option. A signed medical clearance may be uploaded, or the applicant may acknowledge the waiver below.

I am attaching medical clearance signed by my doctor. I choose the applicant waiver.

Signed medical-clearance document, if using that option I understand that it is in my best interest, and recommended by C.H.I.P.S. and the Food and Drug Administration, to receive a medical examination before acquiring hearing aids. If I select the waiver option, I choose not to receive that examination.

Certification and Signature

I understand that the annual income, family size, resources, insurance, medical history, and financial information submitted to C.H.I.P.S. may be verified by phone, letter, email, or credit check. I understand that knowingly omitting or submitting false information may result in denial of assistance at any point.

I certify that the information and documents submitted are complete and accurate. * Type your full legal name as your electronic signature Signature date

Your application contains sensitive personal and financial information. Files are emailed to C.H.I.P.S. for review and removed from the website server after the email attempt.