Maryland Code, Health Occupations § 2-314.8

(1) The name and address of the regular place of business of the audiologist or the hearing aid dispenser;

(2) The license number of the audiologist or the hearing aid dispenser;

(3) The make, model, and serial number of the hearing aid provided;

(4) If the hearing aid is used or reconditioned, a statement that indicates that the hearing aid is used or reconditioned;

(5) The amount charged for the hearing aid;

(6) The total refundable amount of the hearing aid if it is returned within 30 days as provided in the Hearing Aid Sales Act, Title 14, Subtitle 25 of the Commercial Law Article; and

(7) The signature of the audiologist or the hearing aid dispenser.