Get Hearing Screening Report Example
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How to fill out the Hearing Screening Report Example online
Completing the Hearing Screening Report Example online is a straightforward process that ensures accurate documentation of a child's hearing health. This guide will provide you with step-by-step instructions to fill out each section of the form efficiently and effectively.
Follow the steps to successfully complete the hearing screening report.
- Click ‘Get Form’ button to access the hearing screening report and open it in an editable format.
- Begin by entering the child's name and date of birth in the designated fields at the top of the form. This information is essential for proper identification and record-keeping.
- Indicate the HS class or EHS home visitor in the appropriate section to provide relevant context for the screening.
- Complete the AuDX OAE test frequency section. For both the right and left ear, mark the results for each frequency tested: 2000 KHz, 3000 KHz, 4000 KHz, and 5000 KHz.
- In the results section, choose the appropriate option: 'Passed Hearing Screening,' 'Unable to Test,' 'Rescreen,' 'Refer to a Physician,' or 'Refuse Test.' Make sure to provide any necessary comments explaining the results if applicable.
- If a referral is given, either verbally or in written form, check the corresponding box to ensure proper follow-up.
- At the bottom of the form, include your name as the administrator of the test along with the date of the administration.
- Once all fields are completed, review the form for accuracy and make any necessary corrections. Finally, save your changes, and choose to download, print, or share the completed form as required.
Start filling out your hearing screening report online today to ensure accurate health documentation.
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.
Fill Hearing Screening Report Example
HISTORY. Name: Steven Smith. Age: corrected age 6 weeks (corrected for 8 weeks prematurity). Pure tone testing (Symmetric): Right Ear - Mild-Severe Sensorineural Sloping Hearing Loss; Left Ear - Mild-Severe Sensorineural Sloping Hearing Loss. Has child ever had a sudden or rapid progression of hearing loss? If yes, which ear(s)? The following scripts display the level of detail that is appropriate for most parents. In this sample, as a result of the hearing screening of 16,388 babies, the number of infants who passed TEOAE screening was 13,319 infants.
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