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  • Hearing Screening Form Complete

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How to fill out the Hearing Screening Form Complete online

Filling out the Hearing Screening Form Complete online can help streamline the process of documenting student screenings. This guide provides clear, step-by-step instructions to assist users in completing the form accurately and efficiently.

Follow the steps to complete the Hearing Screening Form Complete online.

  1. Click ‘Get Form’ button to access the form and open it in your preferred document editor.
  2. Begin by entering the student's name and student ID in the appropriate fields at the top of the form. Also include their school name and the date of the screening.
  3. In the 'Teacher / Grade' section, input the teacher's name and the grade the student is currently in.
  4. Indicate who the form is to be returned to by filling in the 'Return form to' field and specify the due date in the 'By Date' section.
  5. Select the type of screening being conducted by marking the appropriate box: 'New SAT Eval' or 'Sped Re-Eval/Date of Re-Eval.' If other, specify in the provided field.
  6. For the Vision section, complete the first and second screenings by filling in the corresponding dates, nurse's name, and passing/failing results for both left and right evaluations.
  7. Document the results for near, far, color, and stereopsis vision tests and indicate if a referral is needed. Add any pertinent comments regarding the vision screening.
  8. Next, fill out the Hearing section similarly. Complete both screenings with dates and pass/fail results for each ear. Again, indicate if a referral is necessary and include comments if needed.
  9. Ensure to sign the form where indicated with the nurse’s signature and the date to confirm that the screening is complete.
  10. After completing all sections, review the form for accuracy. Then, you may save the changes, download, print, or share the form as needed.

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Although a hearing screening can alert you to potential hearing problems, a full hearing evaluation performed by a licensed provider is important to fully understand and address your hearing loss effectively.

You'll be shown a graph that indicates your level of hearing sensitivity with frequencies (also called pitch) in Hertz along the top of the graph, and sound levels in decibels along the left side of the graph. Typically, audiograms test frequencies between 250Hz and 8,000 Hz.

When you have a hearing test, the audiologist will complete an audiogram. Learn more about this form. The audiogram is a graph showing the results of a pure-tone hearing test. It will show how loud sounds need to be at different frequencies for you to hear them.

Document each frequency screened in a manner that indicates the decibel it was screened at and whether the result was a PASS or REFER. Use consistent notations with a key indicating which symbols or words denote PASS and REFER so that results are clear to caregivers/guardians and providers.

Earphones will be placed on your head. You will be asked to sit still and not talk. The earphones are connected to a machine that will deliver the tones and different sounds of speech to your ears, one ear at a time. The audiologist will ask you to raise your hand when you hear a sound.

A hearing test is performed in a sound proof room. You will wear headphones or earplugs connected to a device that sends sounds of different volumes and pitches to one ear at a time. You will be asked to respond by raising your hand or pressing a button each time you hear a sound.

Hearing tests check a person's ability to hear the loudness and pitch of sounds. The results are charted on a graph (audiogram) to help pinpoint the severity and causes of hearing problems. Tests include pure tone audiometry, using an audiometer, and speech discrimination tests.

Document each frequency screened in a manner that indicates the decibel it was screened at and whether the result was a PASS or REFER. Use consistent notations with a key indicating which symbols or words denote PASS and REFER so that results are clear to caregivers/guardians and providers.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232