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HEARING SCREENING REFERRAL LETTER Date: To The Parents Of: School: Dear Parent: The School Health Services program routinely screens students for possible hearing problems in order to identify any
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How to fill out hearing screening referral letter

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How to fill out a hearing screening referral letter:

01
Start by addressing the letter to the appropriate recipient, typically the audiologist or the healthcare provider who will be conducting the hearing screening.
02
Include your contact information, such as your name, address, phone number, and email address, so that the recipient can easily reach you if needed.
03
Clearly state the purpose of the letter, which is to request a hearing screening for yourself or someone else. Provide relevant details such as the person's name, age, and any specific concerns or symptoms they may be experiencing.
04
Explain why a hearing screening is necessary, whether it's routine testing, suspected hearing loss, or a referral from another healthcare professional.
05
Include any relevant medical history or current medications that may impact the hearing screening or provide additional context for the healthcare provider.
06
Express any specific requests or preferences, such as requesting a specific date or time for the hearing screening appointment, or asking for a copy of the screening results to be sent to another healthcare provider.
07
Thank the recipient for their attention and consideration, and provide your contact information again in case they need to reach you for any further clarifications or instructions.

Who needs a hearing screening referral letter?

01
Individuals who are experiencing symptoms of hearing loss, such as difficulty understanding speech, ringing in the ears, or a feeling of fullness in the ears.
02
Individuals who have been referred by their primary care physician or other healthcare provider for a hearing screening.
03
Individuals who are required to undergo a hearing screening for occupational or legal reasons, such as for job applications or in legal proceedings.
04
Babies or children who have failed a previous hearing screening or are at risk for hearing loss due to certain medical conditions or genetic factors.
05
Individuals who suspect they may have hearing loss but have not yet been formally assessed or diagnosed by a healthcare professional.
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The hearing screening referral letter is a document used to refer individuals for further evaluation of their hearing.
Healthcare professionals, educators, and caregivers who suspect hearing loss in individuals are required to file a hearing screening referral letter.
To fill out a hearing screening referral letter, one must include the individual's personal information, reason for referral, and any relevant medical history.
The purpose of the hearing screening referral letter is to ensure individuals receive proper evaluation and treatment for their hearing loss.
The hearing screening referral letter must include the individual's name, date of birth, contact information, reason for referral, and any relevant medical history.
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childs Trumbull rescreening Audiology audiologist Ext REFERRAL routinely scheduling recommendations screens

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