Get Hearing Loss Assessment C662 - Wcb Ab

The Hearing Loss Assessment C662 is a crucial document used for assessing hearing loss and its related factors. This guide provides clear instructions on how to fill out this form online, ensuring that users understand each section and can complete it accurately.

Follow the steps to complete your hearing loss assessment form.

1. Press the ‘Get Form’ button to access the Hearing Loss Assessment C662 form and open it in your preferred editing tool.
2. Begin by entering the client's WCB claim number and personal health number at the top of the form. Next, fill in the client's surname, first name, address, city or town, postal code, and telephone number.
3. Provide the client's date of birth by entering the year, month, and day in the appropriate fields. Indicate whether the client is currently working by selecting 'Yes' or 'No'.
4. Section for audiometric testing includes fields like Puretone Audiometry and Speech Audiometry. Fill in the relevant frequency in hertz and the results of the tests in the designated boxes.
5. In the middle ear function section, complete the tympanogram readings for both ears, including any compliance measurements needed.
6. Document the client's hearing difficulties in the background information section by checking all applicable options such as tinnitus, vertigo, and noise exposure.
7. Fill in the details regarding current hearing aids, including style, make, model, serial number, and date purchased.
8. In the results section, indicate the degree and type of hearing loss for both the right and left ears. Ensure to detail any recommendations such as referrals or assessments needed.
9. After thoroughly reviewing the completed form, you can save your changes, opt to download a copy for your records, print the document, or share it as necessary.

Complete your Hearing Loss Assessment C662 online today for efficient processing.