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Provides step-by-step configuration: choose style family and model, select earware colours and retention options, then specify custom ear-tip/earmould materials, venting, locks, wire or tube length, and easywear instant ear-tips with options.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/widex-evoke-menu-ricbte-order-form/509858/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/widex-evoke-menu-ricbte-order-form/509858.png","ImageObject",300,407,{"name":42,"@type":43},"Terk","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-10-05",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",6,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What information is required to complete the order form?","Question",{"text":63,"@type":64},"The form collects purchase/order details, service priority, third-party coverage selections, and patient information such as name, date of birth, ear texture, and impression preferences.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does the form handle custom ear-tip/earmould specifications?",{"text":68,"@type":64},"It supports user instructions language selection and asks whether changes are allowed for custom ear-tip/earmould material, receiver type, and vent size, then provides options for materials, lock types, and venting.",{"name":70,"@type":61,"acceptedAnswer":71},"What are the main steps to configure the hearing aids and accessories?",{"text":72,"@type":64},"Step 1 selects the hearing aid style family, series, model, and receiver/earware options. Step 2 specifies custom ear-tip/earmould details and accessories such as venting and tube or wire length. Step 3 selects EasyWear instant ear-tips and options or returns to Step 2 for custom selections.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},509858,1791841387,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":97,"preview_page_count":4},1099525198933,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","WIDEX EVOKE™ & MENU RIC/BTE ORDER FORM 905.315.8303 | 800.387.7943 | Fax: 905.315.5090 | ESHOP.WIDEX. PRO  \nSOUND LIKE NO OTHER  \nService Priority: q Next Day ($50) q Standard Purchase Order \\#: Date: Contact Name for Changes:  \n\n| Bill To: | Ship To: | Internal Use Only: |\n| --- | --- | --- |\n\nTHIRD PARTY: qVAC/DND/RCMP (w/ accessories) qVAC/DND/RCMP (w/o accessories) q HC/NIHB q ODSP Client/Claim \\#:    \nq WSBC q WCBAB qWCBSK q WCBMB q WCBNS q WSIB q CNESST qWHSCC OTHER:    \nPATIENT INFORMATION  \nName:  \n\n| F | I | R | S | T |  |  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| L | A | S | T |  |  |  |  |  |  |  |  |  |  |  |  |  |\n\nDate of birth:  \n\n| Y | Y | Y | Y | M | M | D | D |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n\nEar Texture: q Soft q Average q Firm  \nImpression: q Open Jaw q Closed Jaw  \nPrevious Model (if applicable):    \nAir Conduction Thresholds  \n\n|  | 250 | 500 | 1000 | 1500 | 2000 | 3000 | 4000 | 8000 |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| L |  |  |  |  |  |  |  |  |\n| R |  |  |  |  |  |  |  |  |\n\nUser Instruction language: q EN q FR q Other:   If necessary due to space limitations, may we change:  \nCustom ear-tip/earmould material? q Yes q No Receiver type (if audiogram permits)? q Yes q No Vent size? q Yes q No  \nSpecial Instructions:  \nSTEP 1-SELECT HEARING AIDS  \n\n| Style | Family | Series | Model | Item Code | 2.4 GHz | Receiver |  |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n| RIC/RITE | EVOKE | 440 q\u003Cbr>330 q\u003Cbr>220 q\u003Cbr>110 q | RIC 10 l r | ERBO |  | S\u003Cbr>M | l r\u003Cbr>l r |\n|  |  |  | FUSION l r | E-FS |  | SMPHP | l r\u003Cbr>l r\u003Cbr>l r\u003Cbr>l r |\n|  |  |  | RIC 312 D l r | ERB2D | ü |  |  |\n\n\n| Style | Family | Series | Model |  | Item Code | 2.4 GHz | EarWare |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| BTE | EVOKE | 440 q\u003Cbr>330 q\u003Cbr>220 q\u003Cbr>110 q | FASHION MINI\u003Cbr>FASHION | l r\u003Cbr>l r | E-FM\u003Cbr>E-FA |  | 0.9mm Thin Tube\u003Cbr>1.4mm Thin Tube Earhook | l r\u003Cbr>l r\u003Cbr>l r |\n|  |  |  | BTE 13 D l r |  | EBB3D | ü | V.2 0.9mm Thin Tube l r\u003Cbr>V.2 1.4mm Thin Tube l r\u003Cbr>Earhook l r |  |\n|  |  |  | FASHION POWER l r |  | E-FP |  | Earhook l r |  |\n|  | MENU | 10 q\u003Cbr>5 q\u003Cbr>3 q | SUPER POWER l r |  | ME-SP |  | Earhook l r |  |\n\n\n| Colour ID |\n| --- |\n| 068 Pearl White l r\u003Cbr>069 Summer Gold l r\u003Cbr>071 Cappuccino Brown l r\u003Cbr>075 Lime Green* l r\u003Cbr>076 Sporty Red l r\u003Cbr>077 Shocking Pink* l r\u003Cbr>078 Mediterranean Turquoise* l r\u003Cbr>081 Tan Silk l r\u003Cbr>118 Tech Black l r\u003Cbr>119 Silver Grey l r\u003Cbr>121 Titanium Grey l r\u003Cbr>123 Autumn Beige l r\u003Cbr>136 Deep Blue l r\u003Cbr>*EVOKE FASHION MINI is not available in Lime Green, Shocking Pink, or Mediterranean Turquoise. |\n\n021 Warm Beige l r  \n022 Brown l r  \n\n| Style | Model | Retention Options | Colour ID |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| CROS1 | CROS-FS l r | RIC (Select earware in Step 2 or 3 on reverse) | 068\u003Cbr>069\u003Cbr>071\u003Cbr>075\u003Cbr>076\u003Cbr>077\u003Cbr>078 | Pearl White Summer Gold Cappuccino Brown Lime Green Sporty Red Shocking Pink\u003Cbr>Mediterranean Turquoise | l r\u003Cbr>l r\u003Cbr>l r\u003Cbr>l r\u003Cbr>l r\u003Cbr>l r\u003Cbr>l r | 081 Tan Silk l r\u003Cbr>118 Tech Black l r\u003Cbr>119 Silver Grey l r\u003Cbr>121 Titanium Grey l r\u003Cbr>123 Autumn Beige l r\u003Cbr>136 Deep Blue l r |\n|  | CROS-FA l r | q Ear hook q Thin Tube (Select earware in Step 2 or 3 on reverse) |  |  |  |  |\n\n1. Compatible with wireless models only, excluding 2.4 GHz models (RIC 312 D and BTE 13 D) . Not compatible with MENU SP.  \nOptions in bold are standard/default  \nWIDEX EVOKE™ & MENU RIC/BTE ORDER FORM 905.315.8303 | 800.387.7943 | Fax: 905.315.5090 | ESHOP.WIDEX. PRO  \nSOUND LIKE NO OTHER  \nPurchase Order \\#: Date: Ship To Account \\#: Patient Name:  \nSTEP 2-SELECT CUSTOM EAR-TIP/EARMOULD AND OPTIONS Or proceed to step 3 to select instant tips and options  \n\n| STYLE |  | RECEIVER/\u003Cbr>THIN TUBE SIZE | MATERIAL/COLOUR |  | WIRE/TUBE LENGTH | LOCK |  | VENTING |  |  |\n| --- | ---","cbCaihBhtgE7B51X","https://ap.wps.com/l/cbCaihBhtgE7B51X","pdf",358914,"English","# Order Details\n## Patient Information\n## Step 1: Select Hearing Aids\n## Step 2: Select Custom Ear-Tip/Earmould and Options\n## Step 3: Select EasyWear Instant Ear-Tips and Options","[{\"question\":\"What information is required to complete the order form?\",\"answer\":\"The form collects purchase/order details, service priority, third-party coverage selections, and patient information such as name, date of birth, ear texture, and impression preferences.\"},{\"question\":\"How does the form handle custom ear-tip/earmould specifications?\",\"answer\":\"It supports user instructions language selection and asks whether changes are allowed for custom ear-tip/earmould material, receiver type, and vent size, then provides options for materials, lock types, and venting.\"},{\"question\":\"What are the main steps to configure the hearing aids and accessories?\",\"answer\":\"Step 1 selects the hearing aid style family, series, model, and receiver/earware options. Step 2 specifies custom ear-tip/earmould details and accessories such as venting and tube or wire length. Step 3 selects EasyWear instant ear-tips and options or returns to Step 2 for custom selections.\"}]","Widex EVOKE & MENU RIC/BTE Order Form | PDF",1791237577]