Last year the first author published two articles in The Hearing Journal reporting on studies she conducted on (1) the effectiveness of an online hearing test and (2) the quality of earmolds made from impressions taken by the purchaser as part of the online acquisition process. 1,2 Both studies demonstrated reasons for serious concern about online hearing aid dispensing, especially when done without benefit of professional services.One reason for concern is that the online hearing tests often failed to determine hearing thresholds accurately. Secondly, the ability of an untrained consumer to make his or her own earmold impressions in order to buy a hearing aid via the Internet is questionable at best. Together, these two studies indicated that dispensing over the Internet can result in ill-fitting hearing aids or even potentially dangerous fittings. ASSESSING THE PURCHASE PROCESSFor the third and concluding article in our series, we had two hearing-impaired subjects purchase hearing aids of their choice via the Internet so we could assess the process and its results.One subject has a medically complicated hearing loss, and we wanted to determine if the online company considered any medical factors before dispensing to a consumer. The second subject was a male with presumed presbycusis.Both subjects were asked to follow the online purchasing process as detailed on the company's web site. We gave them no professional advice in ordering, but members of our team were present for each Internet interaction and for a phone conversation to the online company. SUBJECT ONEThe first subject (JW) is a 71-year-old woman who was diagnosed with a sudden sensorineural hearing loss (SSNHL) over 10 years ago. Her latest and most severe attack occurred in 2005 after she took a plane flight when she had a virus. She was fitted with binaural BTE aids soon after her diagnosis and has worn hearing aids ever since. Her audiogram can be seen in Figure 1. Of particular note are her word-recognition scores, which on average are poor in quiet and more so in noise. She complains of difficulty understanding speakers with lowpitched voices and in group settings such as restaurants. She finds many communication situations very frustrating.JW was recruited for our study after she and her husband came to our university clinic in search of a fitting that would improve her speech recognition. She was wearing a pair of BTE aids from a major manufacturer that were originally fitted at an ENT practice where she was being treated for her SSNHL and which is located outside her home state. Since the fitting, JW reported that her local audiologist has adjusted the instruments "probably more than 50 times." She brought to our clinic a bag full of the earmolds that have been made for her over the years. She said she used most of them from time to time, as she can hear better some days with one and other days with another.