Unitron loss and damage form 2026

1. Click ‘Get Form’ to open the unitron loss and damage form in the editor.
2. Begin by entering your personal information in the 'Claimant’s information' section. Fill in your name, date of occurrence, hearing aid model, and serial number(s).
3. For RIC only fields, specify the receiver type, side, length, and whether it is rechargeable. Select options as applicable.
4. In the 'Description of how hearing instrument(s) was lost or damaged' section, provide a detailed account of the incident.
5. Next, complete the 'Dispenser information' section with your name, account number, address, city, state, phone number, zip code, and fax number.
6. Sign the form in the designated area for the claimant's signature. Ensure this is done in front of a notary public.
7. The notary will complete their section by signing and placing their seal on the document.
8. Finally, return the completed form to Unitron Customer Service via fax at 800.521.5400.

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