Bill of Sale

Products/Services Sold

Qty

Description

Hearing aids with receivers attached (each hearing aid comes with a replacement receiver which can be shipped to the buyer by requesting it from Lively)

Serial number(s): Please See Package

Model number: Lively 5.1

2

Serial number(s): Please See Package

Year(s) of customer support, offered 7 days a week

3

Model number: Lively 5.1

Year(s) of remote hearing aid re-tunings and an ability to speak with an audiologist remotely

3

Batteries

152

Cleaning Kit

1

Wax filter Kit

1

Carrying case

1

Manuals

3

In package

Hearing aid domes

16

Notes:

The buyer has been advised at the outset of his or her relationship with a Lively audiologist that any examination or representation made by a Lively in connection with the business of dispensing this hearing aid, or hearing aids, is not an examination, diagnosis, or prescription by a person licensed to practice medicine in New York, and therefore, must not be regarded as medical opinion.

IN ADDITION TO OTHER RIGHTS, THE BUYER HAS THE RIGHT TO CANCEL THIS PURCHASE FOR ANY REASON AT ANY TIME PRIOR TO TWELVE MIDNIGHT OF THE HUNDRED DAYS AFTER RECEIPT OF THE HEARING AID AND RETURN THE HEARING AID IN THE SAME CONDITION, ORDINARY WEAR AND TEAR EXCLUDED. Lively will pay for return shipment. BY LAW, THE SELLER IS ALLOWED TO RETAIN AN AMOUNT UP TO TEN PERCENT OF THE TOTAL PURCHASE PRICE OF THE CANCELLED HEARING AID, INCLUDING BATTERIES AND CORDS OR ACCESSORIES THERETO, INCLUSIVE OF ALL FEES RELATED TO THE HEARING AID.

Purchaser may contact Lively at 1-800-854-2772 for the address and the office hours available for Lively audiologists for fitting or post-fitting adjustments and servicing of the hearing aids.

Warranty Program

Warranty Period and Covered Services: Lively provides three (3) years of repair warranty and three (3) years of loss and damage coverage for all Lively hearing aid purchases.

All product warranties are in effect from the date of the purchase. Should repair of a Lively hearing aid product be necessary, we will make every effort to provide this service in a timely and efficient manner. To facilitate this service, please return the product with a completed Repair/Remake Service form to Lively in appropriate packaging. A product repaired under warranty maintains the original purchase warranty effective date.

Under Lively's loss and damage policy, any hearing aid, that is stolen, lost or catastrophically damaged can be replaced while the product is under warranty. Note that for hearing aids, the replacement must be for the same buyer and the same ear, and it must include the same options package as the original hearing aid. The following fees apply:

  • Lively hearing aid per-unit deductible: $195

A hearing aid, may be replaced only once under this program, and may not be returned for credit. The effective date of the product warranty on the replacement unit is the same as that of the original unit. Ownership of the stolen, lost or damaged unit reverts to Lively. Should a claim need to be filed, a completed Loss & Damage Claim form is required.

Lively may require that you return the defective device before sending you a replacement. You must ensure that the correct device is returned to Lively. You will not receive a replacement until Lively has received the correct device. If Lively provides you with an advanced replacement (at its discretion) device before we receive your defective device, and you do not return the defective device within the time communicated to you in notification emails, you authorize Lively to charge your original form of payment for the full value of the replacement device.

Standard Return Policy: If the hearing aid purchase is returned for credit within 100 days of the original purchase date, you will receive a full refund of the purchase price of the cancelled hearing aid, including batteries, cords and accessories, and all fees related to the hearing aid. Lively will pay for return shipment. To be eligible for return, hearing aids must be in the same condition, ordinary wear and tear excluded.

Return Policy based on Medical Opinion: Within one (1) year from the date of your hearing aid purchase, you may cancel your hearing aid purchase and receive a full refund of the purchase price if you receive a written opinion from an otolaryngologist, or if no otolaryngologist is available another licensed physician qualified to diagnose diseases of the ear, subsequent to purchasing a hearing aid providing that you either have a hearing impairment for which a hearing aid provides no benefit or have a medical condition which contraindicates the use of a hearing aid and as a result of either condition, you have experienced no improvement in the quality of your hearing.

Out-of-Warranty Repair: Lively will accept for repair and other necessary services any hearing aid or accessory thereof for a period of five (5) years for the date of the hearing aid purchase. Lively shall deliver an itemized bill showing the repair and service provided and the charge therefor. If the charge for the repair or service shall exceed $50, no work will be performed unless the buyer shall have been first advised of the work to be performed, the charge therefor, and shall have approved same.

NOTICE REGARDING MEDICAL OPINION

If you are a resident of Alabama, Colorado, District of Columbia, Florida, Hawaii, Iowa, Kentucky, Massachusetts, Nebraska, New Hampshire, New Mexico, New York, New Jersey, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas or Wyoming, YOU MUST READ AND ACKNOWLEDGE THE TEXT FROM YOUR STATE BELOW REGARDING MEDICAL OPINIONS.

ALABAMA
The purchaser has been advised at the outset of his or her relationship with the hearing instrument apprentice, fitter, or dispenser that any examination(s) or representation(s) made by a licensed hearing instrument apprentice, fitter, or dispenser in connection with the fitting and selling of this hearing instrument(s) is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and, therefore, must not be regarded as medical opinion or advice.

COLORADO
The buyer has been advised at the outset of the buyer's relationship with the dispenser that any examination or representation made by a dispenser in connection with the practice of dispensing, fitting, or dealing in hearing aids is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and, therefore, must not be regarded as medical opinion or advice.

DISTRICT OF COLUMBIA
This hearing aid will not restore normal hearing nor will it prevent further hearing loss. A return visit to a physician who is an ear specialist or audiologist after the purchase of this aid will help you in best adapting to it.

FLORIDA
A hearing aid will not restore normal hearing, nor will it prevent further hearing loss.

HAWAII
The purchaser has been advised at the outset of the purchaser's relationship with the hearing aid dealer and fitter that any examination or representation made by a hearing aid dealer and fitter in connection with the fitting and selling of this hearing aid is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this State and shall not be considered as medical opinion or advice.

IOWA
The purchaser has been advised that any examination or representation made by a licensed hearing aid specialist in connection with the fitting or selection and selling of this hearing aid is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and therefore, must not be regarded as medical opinion or advice.

KENTUCKY
The purchaser has been advised at the outset of his or her relationship with the specialist in hearing instruments that any examination(s) or representation(s) is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and therefore shall not be regarded as medical opinion or advice.

MASSACHUSETTS
This hearing aid will not restore normal hearing nor will it prevent further hearing loss. The sale of a hearing aid is restricted to those individuals who have obtained a medical evaluation from a licensed physician or otolaryngologist. A fully informed adult whose religious or personal beliefs preclude consultation with a physician may waive the requirement of a medical evaluation. The exercise of such a waiver is not in your best health interest and its use is strongly discouraged. It is also required that a person under the age of eighteen years obtain an evaluation by an audiologist in addition to the medical evaluation before a hearing aid can be sold to such person.

NEBRASKA
The purchaser has been advised at the outset of his or her relationship with the hearing instrument specialist that any examination or representation made by a licensed hearing instrument specialist in connection with the fitting and selling of this hearing instrument is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and therefore must not be regarded as medical opinion or advice.

NEW HAMPSHIRE
This hearing aid will not restore normal hearing nor will it prevent further hearing loss.

NEW MEXICO
Buyer has been advised that licensee is not a licensed physician and that the examination and recommendation is made as a hearing aid dispenser or audiologist and not as a medical diagnosis or prescription.

NEW YORK
The buyer has been advised at the outset of his or her relationship with a Lively audiologist that any examination or representation made by a hearing aid dispenser in connection with the business of dispensing this hearing aid, or hearing aids, is not an examination, diagnosis, or prescription by a person licensed to practice medicine in New York, and therefore, must not be regarded as medical opinion.

NEW JERSEY
The purchaser has been advised at the outset of his or her relationship with the hearing aid dispenser that any examination or representation made by a licensed hearing aid dispenser in connection with the practice of fitting and selling of this hearing aid, or hearing aids, is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this State, or by certified audiologists and therefore must not be regarded as medical opinion.

NORTH DAKOTA
Any examination or representation made by a licensed hearing aid specialist in connection with the fitting and selling of this hearing instrument is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and therefore, must not be regarded as medical opinion or advice.

OHIO
The purchaser is advised that any examination, fitting, recommendation, or representation made by a licensed hearing aid dealer or fitter in connection with the sale of this hearing aid is not an examination, diagnosis, or prescription made by a person licensed to practice medicine in this state and therefore must not be regarded as medical opinion or advice.

OKLAHOMA
Any examination or representation made by a licensed hearing aid dealer and fitter in connection with the fitting and selling of this hearing aid is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and therefore must not be regarded as medical opinion or advice. Further, it is recommended that medical advice from a licensed physician should be obtained.

OREGON
It is desirable that a person seeking help with a hearing problem (especially for the first time) consult an ear doctor and obtain a clinical hearing evaluation. Although hearing aids are often recommended for hearing problems, another form of treatment may be necessary.

PENNSYLVANIA
The purchaser has been advised at the outset of his or her relationship with the hearing aid dealer that any examination or representation made by a registered hearing aid dealer and fitter in connection with the practice of fitting and selling of this hearing aid, is not an examination, diagnosis or prescription by a person licensed to practice medicine in this Commonwealth and therefore must not be regarded as medical opinion.

RHODE ISLAND
The purchaser has been advised at the outset of his/her relationship with the hearing aid dealer that any examination(s) or representation(s) made by a licensed hearing aid dealer and fitter in connection with the fitting and selling of this hearing aid(s) is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and therefore must not be regarded as medical opinion or advice.

TEXAS
The client has been advised that any examination or representation made by a licensed hearing instrument dispenser or apprentice permit holder or temporary training permit holder in connection with the fitting and selling of the hearing instrument(s) is not an examination, diagnosis or prescription by a person duly licensed and qualified as a physician or surgeon authorized to practice medicine in the State of Texas and, therefore, must not be regarded as medical opinion or advice.

WYOMING
The purchaser has been advised that any examination or representations made by a licensed hearing aid specialist in connection with either the fitting or selling of this hearing aid is not an examination, diagnosis or prescription by a person licensed to practice medicine in this state and shall not be regarded as medical opinion.

NOTICE REGARDING RETURNS AND ADJUSTMENTS

If you are a resident of AlASKA, CALIFORNIA, COLORADO, CONNECTICUT, GEORGIA, IDAHO, Kentucky, MAINE, MARYLAND, MINNESOTA, NEVADA, New Hampshire, New York, Ohio, OKLAHOMA, Pennsylvania, Rhode Island, TEXAS, VERMONT, VIRGINIA, or WEST VIRGINIA, YOU MUST READ AND ACKNOWLEDGE THE TEXT FROM YOUR STATE BELOW REGARDING RETURNS AND ADJUSTMENTS. PLEASE NOTE OUR STANDARD RETURN PERIOD OF 100 DAYS IS LONGER THAN WHAT MOST STATES REQUIRE.

ALASKA
You may cancel this transaction within 30 days from the date you receive the hearing aid or this notice, whichever is later. You may also cancel this transaction within 60 days from the date you receive the hearing aid or this notice, whichever is later, if the hearing aid dealer is not a licensed physician or a licensed audiologist and if a licensed physician or a licensed audiologist advises you in writing to cancel this transaction.

If you cancel this transaction, the property you traded in, the payments you made under the sale or lease (less certain costs allowed by state law) and any negotiable instrument executed by you will be returned within 20 days following receipt by the hearing aid dealer of your cancellation notice, and the hearing aid dealer will cancel any security interest arising out of the sale or lease.

CALIFORNIA
Purchase may contact Lively at (800) 854-2772 for the address and the office hours available for Lively audiologists for fitting or post-fitting adjustments and servicing of the hearing aids.

This hearing aid is warranted to be specifically fit for the particular needs of you, the buyer. If the hearing aid is not initially fit for your particular needs, it may be returned to the seller within 45 days of the initial date of delivery to you. If you return the hearing aid, the seller will either adjust or replace the hearing aid or promptly refund the total amount paid. This warranty does not affect the protections and remedies you have under other laws.

COLORADO
The buyer has been advised at the outset of the buyer's relationship with the dispenser that any examination or representation made by a dispenser in connection with the practice of dispensing, fitting, or dealing in hearing aids is not an examination, diagnosis, or prescription by a person licensed to practice medicine in this state and, therefore, must not be regarded as medical opinion or advice.

THE BUYER HAS THE RIGHT TO CANCEL THIS PURCHASE FOR ANY REASON AT ANY TIME PRIOR TO 12 MIDNIGHT ON THE 100th CALENDAR DAY AFTER RECEIPT OF THE HEARING AID BY GIVING OR MAILING THE DISPENSER WRITTEN NOTICE OF CANCELLATION AND BY RETURNING THE HEARING AID, UNLESS THE HEARING AID HAS BEEN SIGNIFICANTLY DAMAGED BEYOND REPAIR WHILE THE HEARING AID WAS IN THE BUYER'S CONTROL.

The dispenser will promptly refund all moneys paid for the purchase of a hearing aid if it is not delivered to the consumer within the 30-day period. The sale is void and unenforceable if the hearing aid being purchased is not delivered to the consumer within 30 days after the date the written contract is signed or the receipt is issued, whichever occurs later.

CONNECTICUT
THE BUYER HAS THE RIGHT TO CANCEL THIS PURCHASE OR RENTAL FOR ANY REASON AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRTIETH CALENDAR DAY AFTER RECEIPT OF THE HEARING AID. A CANCELLATION FEE OF TWELVE PER CENT OF THE PURCHASE PRICE MAY BE IMPOSED.
ANY BUYER WHO ORDERS A HEARING AID AND LEAVES A DEPOSIT OF ONE HUNDRED DOLLARS OR MORE WITH THE SELLER SHALL BE ENTITLED TO CANCEL SUCH ORDER AND DEMAND A FULL REFUND OF SUCH DEPOSIT, LESS ANY EXAMINATION COSTS, IF THE BUYER IS UNABLE TO INSPECT THE HEARING AID AT THE SELLER'S PLACE OF BUSINESS WITHIN FORTY-FIVE DAYS AFTER THE DATE THE SELLER RECEIVES THE DEPOSIT.

If buyer returns the hearing aid in the same condition as when purchased, ordinary wear and tear excepted, within thirty days of the date of receipt of such hearing aid by such purchaser, such buyer shall be entitled to free adjustment of such hearing aid or the return of the full purchase price of the hearing aid and accessories as itemized on the bill of sale.

GEORGIA
I READ, UNDERSTAND AND HAVE SIGNED OR INITIALED A COPY OF THE REFUND AND RETURN POLICY. THE POLICY STATES IF, AND UP UNTIL WHAT DATE, I CAN RETURN THE HEARING AID FOR A FULL REFUND, A PARTIAL REFUND OF WHAT PERCENTAGE, OR A FULL OR PARTIAL CREDIT. THE POLICY ALSO IDENTIFIES WHAT FEES, IF ANY, FOR SERVICES WILL BE REFUNDED OR CREDITED WHEN THE HEARING AID IS RETURNED FOR REFUND OR CREDIT.

IDAHO
This bill of sale is null and void and unenforceable if the hearing aid being purchased is not delivered to the buyer within thirty (30) days of the date the written contract is signed. In the event the hearing aid is not delivered to the consumer within thirty (30) days of the date the written contract is signed, the licensee shall promptly refund any and all moneys paid for the purchase of the hearing aid.

KENTUCKY
CLIENT'S RIGHT TO CANCEL WITHIN 30 DAYS

THE CLIENT HAS THE RIGHT TO CANCEL THIS PURCHASE FOR ANY REASON AT ANY TIME PRIOR TO MIDNIGHT OF THE 30TH CALENDAR DAY AFTER ACTUAL RECEIPT OF THE HEARING INSTRUMENT(S). YOU MAY CANCEL THE PURCHASE BY NOTIFYING THE SELLER THAT YOU DO NOT WANT THE HEARING INSTRUMENT(S) BY MAILING A NOTICE BEFORE THE DAY LISTED ON THE LAST PAGE OF THIS BILL OF SALE TITLED NOTICE OF RETURN TO THE SELLER AT: 41 WEST 25TH ST, 3RD FLOOR, NEW YORK, NY 10010 UPON CANCELLATION, THE SELLER MAY KEEP UP TO 10% OF THE SELLING PRICE.

MAINE
A 30-day trial period begins on the delivery date. Within the 30-day trial period, the dealer licensee shall contact the purchaser and provide any service, fitting or repair that may be necessary for the beneficial and comfortable use of the hearing aid(s).

MARYLAND
You may cancel this purchase for any reason, at any time within 30 days after the date of delivery of the hearing aid. To cover the costs of dispensing the hearing aid, the seller may withhold from the refund 10 percent of the purchase price or the seller's actual costs up to 20 percent of the purchase price.
If you decide to cancel this contract:

  1. You must provide notice of the cancellation in writing, within 30 days of the date of delivery of the hearing aid, to (the seller) at address of seller; and

  2. You must make the hearing aid available to the seller, in substantially as good condition as when you received it.

MINNESOTA
MINNESOTA STATE LAW GIVES THE BUYER THE RIGHT TO CANCEL THIS PURCHASE FOR ANY REASON AT ANY TIME PRIOR TO MIDNIGHT OF THE 45TH CALENDAR DAY AFTER RECEIPT OF THE HEARING AID(S). THIS CANCELLATION MUST BE IN WRITING AND MUST BE GIVEN OR MAILED TO THE AUDIOLOGIST OR CERTIFIED DISPENSER. IF THE BUYER DECIDES TO RETURN THE HEARING AID(S) WITHIN THIS 45-CALENDAR-DAY PERIOD, THE BUYER WILL RECEIVE A REFUND OF THE TOTAL PURCHASE PRICE OF THE AID(S) FROM WHICH THE AUDIOLOGIST OR CERTIFIED DISPENSER MAY RETAIN AS A CANCELLATION FEE NO MORE THAN $250.

NEVADA
Buyers may contact Lively for follow-up appointment to take place no later than 21 days after hearing aid is delivered. CALL (800) 854-2772

NEW HAMPSHIRE
You have the right to cancel this purchase or rental for any reason within 30 days after receiving the hearing aid.

NEW YORK
IN ADDITION TO OTHER RIGHTS, THE BUYER HAS THE RIGHT TO CANCEL THIS PURCHASE FOR ANY REASON AT ANY TIME PRIOR TO TWELVE MIDNIGHT OF THE 45TH CALENDAR DAYS AFTER RECEIPT OF THE HEARING AID AND RETURN THE HEARING AID IN THE SAME CONDITION, ORDINARY WEAR AND TEAR EXCLUDED. Lively will pay for return shipment. BY LAW, THE SELLER IS ALLOWED TO RETAIN AN AMOUNT UP TO TEN PERCENT OF THE TOTAL PURCHASE PRICE OF THE CANCELLED HEARING AID, INCLUDING BATTERIES AND CORDS OR ACCESSORIES THERETO, INCLUSIVE OF ALL FEES RELATED TO THE HEARING AID.

Purchase may contact Lively at (800) 854-2772 for the address and the office hours available for Lively audiologists for fitting or post-fitting adjustments and servicing of the hearing aids.

OHIO
Right To Return The Hearing Aid Within Thirty Days And Receive A Refund Under Ohio law (section 1345.30 of the Revised Code): A consumer has the right to return a hearing aid for any reason within thirty days after it is originally delivered to the consumer or a person acting on the consumer's behalf and receive a refund of the consideration paid for the hearing aid less an amount specified by the hearing aid dealer or fitter, physician, or audiologist to cover expenses incurred in connection with the hearing aid not later than fifteen days after presenting proof of payment for the hearing aid and returning it in the condition in which it was received, except for normal wear and tear. In this case the amount deducted from the refund will be $ 0.

OKLAHOMA
OKLAHOMA STATE LAW GIVES THE PURCHASER THE RIGHT TO CANCEL THIS PURCHASE FOR ANY REASON BY RETURNING THE HEARING AID TO THE HEARING AID PROVIDER AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRTIETH CALENDAR DAY AFTER RECEIPT OF THE HEARING AID. BY LAW, THE HEARING AID PROVIDER MAY BE ENTITLED TO A CANCELLATION FEE NOT TO EXCEED TEN PERCENT (10%) OF THE TOTAL PURCHASE PRICE FOR THE HEARING AID OR ONE HUNDRED FIFTY DOLLARS ($150.00) PER HEARING AID, WHICHEVER IS LESS, TO COVER THE COSTS INCURRED BY THE HEARING AID PROVIDER. IF THE PURCHASER RETURNS THE HEARING AID WITHIN THE THIRTY-DAY PERIOD, THE PURCHASER WILL RECEIVE A REFUND OF THE FULL PURCHASE PRICE

IF THE HEARING AID PROVIDER FAILS TO COMPLY WITH THIS PROVISION, COMPLAINTS SHOULD BE FORWARDED TO:

OKLAHOMA STATE DEPARTMENT OF HEALTH
OCCUPATIONAL LICENSING DIVISION
1000 N.E. 10TH STREET
OKLAHOMA CITY, OKLAHOMA 73117

DURING THE THIRTY-DAY PERIOD, IF THE HEARING AID IS RETURNED FOR REPAIRS OR ADJUSTMENTS THE THIRTY-DAY PERIOD SHALL BE TOLLED UNTIL RETURN OF THE AID(S) TO THE PURCHASER.

PENNSYLVANIA
If a hearing aid is returned within 30 days of date of delivery in the same condition, ordinary wear and tear excluded, you are entitled to a refund of the portion of the purchase price of the hearing aid and accessories as itemized on the receipt and above, less the cancellation fee stated above. If a cancellation fee is imposed the nonrefundable amount for each aid and accessories cannot exceed 10% of the purchase price of the hearing aid and accessories or $150.00 per aid and accessories, whichever is less. If you cancel your order prior to delivery, you are entitled to full refund of the purchase price of the aid and accessories, and a full refund for services not yet rendered.

RHODE ISLAND
> The purchaser has a thirty (30) day trial period during which time she/he may return the instrument, in the original condition less normal wear, with no further financial obligation. This product is protected by Chapter 45 of Title 6 entitled «Enforcement of Assistive Technology Warranties» which shall be made available by the dispenser, upon request.

TEXAS
LIVELY recommends a follow-up appointment within thirty (30) days after the hearing instrument fitting. CALL (800) 854-2772

VERMONT
Notice of 45 day trial period. You have 45 days from the day that you receive your hearing aid to try it out and decide whether you wish to keep it. The 45 day period does not include any days that the hearing aid is in the possession of the dispenser, manufacturer, repairer or their agents. If, in your opinion, during the 45 day trial period you feel that the hearing aid is not satisfactory for you, you have a right to return the hearing aid and receive a refund of the full product price. However, if you have damaged the hearing aid, your refund will be reduced by the reasonable cost of damage. In order to return the hearing aid and receive a refund, contact LIVELY at (800) 854-2772, 41 WEST 25TH ST, 3RD FLOOR, NEW YORK, NY 10010 not later than 45 days after delivery of the hearing aid.

VIRGINIA
Within 30 days of the date of delivery, any buyer of a hearing aid shall be entitled to return the hearing aid for any reason, provided such aid is returned in satisfactory condition. Such purchaser shall be entitled to a replacement or a refund of all charges paid, less a reasonable charge for medical, audiological, and hearing aid evaluation services provided by the hearing aid specialist.

WEST VIRGINIA
You have the right to return the hearing aid to the dealer from whom it was purchased at any time within thirty (30) days after receipt of the aid and rescind the purchase agreement except for reasonable fitting and examination charges ($125.00 maximum fitting charge), if the aid does not function properly or cannot be adjusted to correct the deficiency in your hearing or is otherwise unsatisfactory. The aid so returned must be without damage.

NOTICE OF STATE BOARDS AND REGULATORS

ALASKA
Buyer may file a written complaint about a hearing aid or a hearing aid dealer with the Alaska Department of Commerce, Community, and Economic Development at:
P.O. Box 110800
Juneau, AK 99811-0800

COLORADO
Dispensers who are licensed, certified, or registered by the department of regulatory agencies are regulated by the Division of Professions and Occupations in the Department of Regulatory Agencies. Any complaints can be filed against the licensee by contacting the Office of Hearing Aid Provider Licensure. The Office of Hearing Aid Provider Licensure is below:

Colorado Office of Audiology and Hearing Aid Provider Licensure within the Division of Professions and Occupations
1560 Broadway, Suite 1350
Denver, CO 80202
(303)894-7800
https://www.colorado.gov/pacific/dora/Hearing_Aid_Provider

DISTRICT OF COLUMBIA
Complaints with respect to this purchase may be submitted to the Office of Consumer Protection of the District of Columbia at:
Office of the Attorney General
Office of Consumer Protection
441 4th Street, NW
Washington, DC 20001

FLORIDA
Any complaint concerning the hearing aid and guarantee therefor, if not reconciled with the licensee from whom the hearing aid was purchased should be directed by the purchaser to the:
Florida Department of Health
Department of Health Consumer Services Unit
Bald Cypress Way Bin C-75
Tallahassee, FL 32399-3260
(850)488-0796.

IDAHO
If you have general questions or questions regarding procedures for filing complaints against anyone license to dispense hearing aids, you may contact:
Idaho Bureau of Occupational Licenses
PO Box 83720, Boise, Idaho 83720-0063
Phone — (208) 334-3233
https://ibol.idaho.gov/IBOL/BoardPage.aspx?Bureau=shs

KENTUCKY
ANY COMPLAINTS CONCERNING THE SALE OR SERVICE OF THIS HEARING INSTRUMENT WHICH ARE NOT CORRECTED BY THE SPECIALIST IN HEARING INSTRUMENTS SHOULD BE DIRECTED TO:
KENTUCKY LICENSING BOARD FOR SPECIALISTS IN HEARING INSTRUMENTS, COMMONWEALTH OF KENTUCKY, FRANKFORT, KENTUCKY 4060.

LOUISIANA
Louisiana State Board of Hearing Aid Dealers
308 Gregory Dr.
Luling, LA 70070
(504)655-0383

MAINE
If you wish to file a complaint regarding this purchase, contact:
Complaint Coordinator, Office of Professional and Occupational Regulation
35 State House Station, Augusta, ME 04333
Telephone: (207) 624-8660
Website: www.maine.gov/professionallicensing

MONTANA
If you have any questions regarding your consumer rights with respect to hearing aids and related devices, contact the state Board of Hearing Aid Dispensers at:
301 South Park, 4th Floor
PO BOX 200513
Helena, Montana 59620-0513
(406)841-2202

NEW HAMPSHIRE
Complaints which arise with respect to this transaction may be submitted in writing to the following:
New Hampshire Consumer Protection and Antitrust Bureau,
Division of Public Protection, New Hampshire Department of Justice
33 Capitol Street
Concord, NH, 03301
(603)271-3658

NEW MEXICO
Speech-Language Pathology, Audiology and Hearing Aid Dispensing Practices Board
PO BOX 25101
Santa Fe, NM 87504
Telephone: (505)476-4622

OKLAHOMA
IF THE HEARING AID PROVIDER FAILS TO COMPLY WITH STATE REQUIREMENTS FOR RETURNS, COMPLAINTS SHOULD BE FORWARDED TO:
OKLAHOMA STATE DEPARTMENT OF HEALTH
OCCUPATIONAL LICENSING DIVISION
1000 N.E. 10TH STREET
OKLAHOMA CITY, OKLAHOMA 73117

OREGON
Complaints regarding the purchase of hearing aids may be made to:
Oregon Health Licensing Agency
1430 Tandem Avenue NE
Suite 180
Salem, OR 97301
(503) 373-2024
https://www.oregon.gov/OHA/PH/HLO/Pages/Contact-Us.aspx

PENNSYLVANIA
If your rights are violated, you may contact the State Bureau of Consumer Protection, the Pennsylvania Department of Health in Harrisburg, or your local district attorney.

TENNESSEE
A buyer may contact the below Council regarding complaints on any matter relating to the fitting and dispensing of hearing instruments: Tennessee Council for Hearing Instruments Specialists
665 Mainstream Drive, 2nd Floor
Nashville, TN 37243
(615) 741-5735 local or 1-800-778-4123 nationwide

TEXAS
If you have a complaint against a licensed hearing instrument dispenser or apprentice permit holder or temporary training permit holder, you may contact:
Texas Department of Licensing and Regulation
P.O. Box 12157
Austin, Texas 78711
Telephone (512) 463-6599, Toll-Free (in Texas): (800) 803-9202
www.tdlr.texas.gov

NOTICE OF RETURN

NOTICE OF RETURN
To return your purchase, please call (800) 854-2772 and we will instruct you how to deliver the hearing aids back to Lively.

NO REFUND WILL BE GIVEN UNTIL THE HEARING AID OR HEARING AIDS ARE RETURNED TO LIVELY.

If you cancel this transaction, the property you traded in, the payments you made under the sale will be returned within 15 days.

The hearing aid must be returned to Lively in as good a condition as when received, less normal wear and tear.