Manufacturer Request for Valuation Practice Name(Required) Contact Name(Required) Contact Phone Number(Required) Contact Email(Required) Manufacturer Name(Required) Manufacturer Representative Requesting Valuation(Required) Source of Payment(Required) Upon receipt of this request and verification from HAA representative, please direct your customer to the link below to complete our Preliminary Questionnaire form to allow for a timely completion of their valuation Agree Δ Please direct your customer to this link – https://hearingassetadvisors.com/potential-sale-practice
