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  • Mn School Hearing Screening Worksheet 2018

Get Mn School Hearing Screening Worksheet 2018-2025

En date Rescreen date Any parent/teacher/child concerns about hearing? Visual Inspection External inspection Internal inspection/otoscopy (if Initial screen PASS/REFER PASS/REFER Rescreen PASS/REFER PASS/REFER done) If REFER, please describe findings: Pure tone audiometry Right ear 500 Hz, 25 dB 1000 Hz, 20 dB 2000 Hz, 20 dB 4000 Hz, 2.

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How to fill out the MN School Hearing Screening Worksheet online

Filling out the MN School Hearing Screening Worksheet is an important step in assessing the hearing health of students. This guide provides a clear and user-friendly approach to complete the form online, ensuring accurate information is captured for effective hearing screenings.

Follow the steps to fill out the MN School Hearing Screening Worksheet online.

  1. Click the ‘Get Form’ button to obtain the MN School Hearing Screening Worksheet and open it for editing.
  2. Begin by entering the child’s name and date of birth in the designated fields. This ensures the form is personalized and linked to the right individual.
  3. Fill in the teacher’s name and grade, which provide context for the screening session. These details can help track the child’s progress academically and hearing healthwise.
  4. Record the screening date and rescreen date in the specified sections. This information helps to monitor the timelines for auditory assessments.
  5. Address any parent, teacher, or child concerns about hearing in the provided space. This section is vital for noting specific issues that may need attention during the screening.
  6. Conduct a visual inspection of the child’s hearing health. Document the external inspection and internal inspection/otoscopy results as appropriate.
  7. Input the results of pure tone audiometry tests for both the right and left ear across various frequencies (500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, and 6000 Hz). Indicate whether the initial screen and rescreen results are 'PASS' or 'REFER' as applicable.
  8. If tympanometry was performed, document the results in the optional section provided, noting the outcomes for initial and any subsequent screenings.
  9. Once all necessary fields are completed, review the information for accuracy. Then, save your changes. You will have the option to download, print, or share the finalized form.

Complete the MN School Hearing Screening Worksheet online today to ensure a thorough and efficient hearing health assessment.

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Your test results will be displayed on a graph called an audiogram that shows the softest sounds you can hear at their individual pitches or frequencies. The vertical axis (up and down line) shows the volume of the sounds. The horizontal axis (the line that goes across) represents the pitch or frequency of the sound.

A pass result is documented if responses are obtained in both ears to pure-tone air-conduction stimuli at 25 dB HL at 1000 Hz, 2000 Hz, and 4000 Hz. A referral is documented if there is an absent response to pure-tone air-conduction stimuli at 25 dB HL at any screening test frequency in either ear.

How to Read an Audiogram Y-Axis: Sound Intensity Levels. ... X-Axis: Sound Frequency. ... Healthy Hearing: -10 dBHL – 14 dBHL. ... Slight Hearing Loss: 15 dBHL – 25 dBHL. ... Mild Hearing Loss: 26 dBHL – 40 dBHL. ... Moderate Hearing Loss: 41 dBHL – 55 dBHL. ... Moderately-Severe Hearing Loss: 56 dBHL – 70 dBHL. ... Severe Hearing Loss: 71 dBHL – 90 dBHL.

The range for normal hearing is defined as hearing thresholds of -10 to 15 dB at all frequencies (0 to 20 dB when testing babies through the speakers).

Recommended Early Hearing Detection and Intervention (EHDI) benchmarks include screening for hearing loss before 1 month of age, diagnostic evaluation before 3 months of age, and enrollment in early intervention before 6 months of age, known as the 1-3-6 benchmarks.

The numbers on the top of the audiogram represent pitch. When reading them from left to right, pitch changes from low to high (bass to treble). The numbers running down the side of the audiogram represent loudness level. When reading from top to bottom, the loudness changes from soft to loud.

Here are some things you can do ahead of time to help prepare them for the experience. Desensitize your child's ears. During the audiology appointment, there is going to be a lot of attention placed on your child's ears. ... Practice wearing headphones. ... Work on repeating words on cue. ... Try a conditioned play activity.

Normal = less than 25 db HL. Mild = 25-40 db HL. Moderate = 41-65 dB HL. Severe = 66-90 db HL.

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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
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
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
altaFlow
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