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Abstract Background: A six-week design thinking sprint conducted by NAL identified several opportunities to address client and clinician needs in the time between a client booking an appointment and attending the appointment. It was unclear whether these needs can be addressed by teleaudiology, and how or where it could be utilised. Objectives: To explore whether (1) clients and clinicians have unmet needs before hearing appointments, and (2) to identify opportunities where teleaudiology can address these needs. Methods: To gain an appreciation for the opportunities and challenges that occur during initial hearing appointments, fifteen ethnographic observations were conducted across seven clinics from both public and private hearing service providers in rural and regional settings in New South Wales and Victoria, Australia. Additionally, 18 semi-structured qualitative interviews were conducted based on COM-B health behaviour change model. Interview transcripts were thematically analysed to explore insights, assumptions and experiences of first hearing appointments. Results: The ethnographic observations identified a large variation in clients' consideration of their hearing difficulties and needs before the appointment, The interviews revealed the converging needs of both clients and their clinicians to feel more prepared, motivated before they meet in person and to develop trust and rapport during that first appointment. Conclusion: Opportunities for using teleaudiology before the first appointment include providing unbiased, factual information about hearing-related topics to clients, and gathering useful self-reported information from clients to save time during the first hearing appointment.