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Get Ent Audiology Referral Form - Nuh
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How to fill out the ENT AUDIOLOGY REFERRAL FORM - NUH online
Filling out the ENT Audiology Referral Form is a crucial step in ensuring that individuals receive the appropriate audiology services. This guide provides a detailed overview of each section of the form, making the process straightforward and efficient for users.
Follow the steps to complete the form accurately.
- Click the ‘Get Form’ button to access the ENT Audiology Referral Form and open it for editing.
- Enter the patient's sticky label and contact number(s) in the designated section. This information is vital for the audiology team to reach out regarding the patient's appointment and care.
- Identify the source of referral by selecting an option: CDU, Children’s Clinic, or Others. If selecting 'Others,' please specify the source in the provided space.
- Fill in the contact person's name and number. This should be someone who can be reached for further communication.
- Select the type of referral from the options provided, such as Basic Hearing Test for Adults/Pediatrics, Central Auditory Processing Disorder Test, Hearing Aid Evaluation, Auditory Brainstem Response, Tinnitus Counseling, or others. Ensure to specify any additional services if applicable.
- Provide a provisional diagnosis in the relevant section. This is important for the audiology staff to have context regarding the referral.
- Sign and date the form to confirm authenticity. Include your clinic's stamp in the designated area. This legitimizes the referral.
- Once the form is complete, ensure to save your changes. You can download, print, or share the form as needed for your records or to hand in on the day of the appointment.
Complete your ENT Audiology Referral Form online today for a seamless referral process.
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You should consider referring patients to audiology when they experience symptoms like hearing loss, ringing in the ears, or balance issues. Timely referrals can lead to effective interventions and improved quality of life. To facilitate the referral process, the ENT AUDIOLOGY REFERRAL FORM - NUH is an excellent tool.
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