Get Mn School Hearing Screening Worksheet 2022-2026

The MN School Hearing Screening Worksheet is essential for documenting hearing assessments for students. This guide will walk you through each section of the worksheet, providing clear instructions to ensure you complete the form accurately and efficiently.

Follow the steps to complete the worksheet online.

1. Press the ‘Get Form’ button to access the worksheet and open it in your editing tool.
2. Begin by entering the child's name in the designated field at the top of the form.
3. Fill in the screen date to indicate when the hearing screening took place.
4. Provide the child's date of birth to ensure accurate record-keeping.
5. If applicable, specify the rescreen date for follow-up screenings.
6. Input the name of the child's teacher, as this can assist in communication and follow-ups.
7. Record any concerns related to hearing from parents, teachers, or the child themselves in the respective space.
8. Indicate the child's grade to provide context for the screening results.
9. Conduct a visual inspection and document findings in the appropriate section.
10. Mark whether the initial screen resulted in a PASS or REFER for hearing.
11. If a rescreen was conducted, again document whether it resulted in a PASS or REFER.
12. For pure tone audiometry, complete the right ear and then the left ear sections, marking PASS or REFER for each frequency tested.
13. Note if tympanometry was performed; if so, record results under the optional procedure section.
14. Documentation of any later rescreen, including the date and results, should also be captured if applicable.
15. After completing all fields, save changes, download, print, or share the worksheet as necessary.

Complete the MN School Hearing Screening Worksheet online today to ensure accurate and timely hearing assessments.