After the hearing aid has been ordered and sent to the hearing aid dispenser, it is ready to be fitted to the patient. In this process, the hearing aid is inserted into the patient's ear, and the acoustic performance of the aid is evaluated. This can be accomplished by using Real Ear equipment or by sound field%u2013aided test results.

With the Real Ear equipment, a Real Ear aided response can be obtained, and the insertion gain of the aid can be measured. This gain can be compared to the target gain generated by a particular prescriptive method chosen by the dispenser (eg, NAL), and the hearing-aid settings can be adjusted until a reasonable match is observed. In addition to the gain, similar adjustments are made to the total output of the aid to ensure that the aid does not exceed the patient's loudness discomfort levels.

After Real Ear measurements are taken, the patient may be placed in a sound booth where aided sound-field testing of the speech reception threshold and the speech discrimination in quiet and in noise can be made. The difference between the aided and the unaided measures (ie, functional gain) provides a general indication of the benefit provided by the hearing aid.

Once the hearing aid has been fitted and evaluated, the patient is given a general orientation concerning the hearing aid, including all the components of the device, how to insert and remove the aid, the care and maintenance of the aid, and how and when to change batteries.

During the orientation, the patient is counseled about the use of the aid in various settings, common problems faced by individuals using hearing aids in these settings, and strategies to maximize hearing aid benefit.

Questions that the patient may have concerning wearing and using the aid are answered. If the patient appears to understand how to insert and remove the hearing aid and understands how to turn the aid on and off and adjust the volume control, he or she is allowed to leave with the aid.

In most settings, the hearing aid is dispensed with a 30-day trial period, and the dispenser sets up 2-3 appointments with the patient during this time. During these follow-up visits, the patient's ear mold may need to be modified for a more comfortable fit or to reduce feedback problems.

Near the end of the trial period, the dispenser may retest the patient in the sound field to obtain aided sound-field measures. The dispenser also may obtain aided measures of the patient's self-assessed hearing handicap to assess the patient's subjective perception of the benefits of the hearing aid.

If the patient decides to purchase the hearing aid, then the warranty for the aid begins. Most hearing aids come with at least a 1-year warranty. Extended warranties (up to 3 y) also are available. These types of warranties are most appropriate for children or other individuals who may be at risk of damaging the hearing aid.

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