Forms and Resources

Forms

Forms

Download the complete 2019 Chapter Dinner Information and Reservation Form Here.

OR

Select your options as shown , and   download the fillable Reservation form

   
ANNUAL DINNER-Menu selections

(1)    Grilled Flank Steak – Mushroom Marsala sauce  –whipped potatoes & asparagus
(2)    Chicken French in Lemon/Sherry/Butter sauce –whipped potatoes & asparagus
(3)    3-Cheese Manicotti –house made Marinara

House Salad, and Strawberry Shortcake
$26.00 per person (includes tax & gratuity)

Questions?    Please email, or call, Sue Miller at [email protected]; or, phone,
585-924-8933.
Convention volunteer Registration Form
If you  volunteer at our National Convention you will receive a discount on your Registration fee. 
There are four volunteer positions available: Airport (greet those coming to the Convention as they arrive), information booth (located at the Convention center), registration and workshop (help provide smooth operation in these areas).

If you would like to volunteer please contact Sue Miller [email protected]
Download the form below (either the MS Word file or the .PDF), fill in, and mail to National; be sure to keep a copy. The registration fees on the forms reflect your discount however you must also contact Sue Miller to register your position with her prior to the Convention.
VOLUNTEER REGISTRATION (.DOCX)
VOLUNTEER REGISTRATION (.PDF)
Note: Most forms here are fillable after downloading. They must be saved to your computer before you can fill them out

2019 Scholarship Forms Now Available

2019 Scholarship Reference Letter
2019 Scholarship Application, hand (pen) fillable
NOTE:  You will need  to print three copies of the Scholarship Reference Letter regardless of the version of the Scholarship Application you use.
 Download this  the 2019 Scholarship form  print it, fill and mail it to the address included on the form. 

ADVOCACY 

Judy Markowski, chair of our Chapter's Legislative Committee, has updated the New York State Legislator form.
Download the form, fill it in and save it for future use. NOTE: You may want to make a copy of this form before you fill it in and save the "blank" so that you can update it as needed.

Find your New York Legislators below

​​​​ ​​ New York State Assembly:

Publications

Our Rochester chapter provides a number of publications, which benefit people with hearing loss. Our award-winning Newsletter with its extensive variety of content, our patient brochure which provides valuable information for those who may have to enter the hospital and our Accessibility Handbook, which discusses 
large venue listening systems and principles which apply to home systems, are all invaluable.

Be sure to take a look at our Chapter’s Brochure for more information about who we are and what we do to support people with hearing loss. We have a lot to offer.

​National has developed a Work Toolkit which provides valuable information for those currently in the workforce.

HLAA Patient Brochure
HLAA Employment Toolkit
HLAA Rochester Chapter Brochure

Do you have questions about the Americans with Disability Act?

A Guide to Hearing Tests

Summary of ADA
A Guide to Hearing Tests
Contact our Region 2 Center. They will provide direct answers to your questions about the ADA.

Region 2 (New Jersey, New York, Puerto Rico, U.S. Virgin Islands)

Northeast ADA Center  203 Dolgen Hall Ithaca, NY. 14853
607-255-6686 [email protected]
www.northeastada.org 

Talk to an ADA Specialist:1-800-949-4232 National office
   

Holidays with Hearing Loss

Holidays can be a real challenge for people with Hearing loss. Feeling frustrated and excluded are common. Here are some suggestions to help get through challenging holiday situations.
Holidays with Hearing Loss

Resouces/ vendors

Find more helpful Information on our "Hearing Loss Tips" page

Many devices cannot be obtained locally. The link below will provide a list of vendors and local service providers.
Hearing Loss Tips
Resources/Vendors

Emergency Preparedness

Being prepared for an emergency is always a good idea. Having a plan relieves a tremendous amount of stress. Although we can't prepare for every single possible scenario, we all can do something to make our situation easier or at least tolerable during an emergency.

People who have a disability or medical condition that requires special attention are in the best position to know what addtional steps they will need to manage until communication is restored, help arrives, or the emergency is over.

Those of us with hearing loss can take steps to prepare ourselves for a possible emergency situation. The following links will provide guidence to planning and preparing for a variety of possible events.

Information From the Red Cross and FEMA (Federal Emergency Management

New York Communications Resources

Red Cross/FEMA
NY Communications Resources

Scott Smith, Captain and Paramedic
Lise Hamlin, HLAA Director of Public Policy
   (From an HLAA Webinar)

Some items you may consider having on hand, in addtion to recommended amounts of food and water are:

1. Extra hearing aid/CI batteries. Keep an extra pack or two and rotate them.

2. If you have hearing aids or CI that are old but still work or can be repaired, pack them in your "preparedness" bag. The ones you use on a daily basis may get wet, dropped or lost.

3. If you can benefit from a personal listener, have it (and a headset) handy, in the event you don't have access  your hearing aids...don't forget batteries for it.

4. You may consider a "hand crank" charger/ radio.

5. If you can manage a small portable generator, keep it charged and it may be just enough to keep you CI batteries, cell phone, radio, or rechargeable flashlight batteries charged

​Be sure you understand how to use your devices!
HLAA Preparedness Webinar