Get the free Newborn Hearing Order Form 020408indd - uconnucedd

Enhanced Child Find Through Newborn Hearing Screening A Parents Guide: Newborn Hearing Screening This 18 minute DVD is an educational resource to expedite the identification of hearing loss in newborns.

How to fill out newborn hearing order form

How to fill out a newborn hearing order form:

1. Obtain the form: Start by obtaining a copy of the newborn hearing order form. You can typically request this form from the hospital where your baby was born or from your pediatrician.
2. Fill in personal information: The form will require you to provide personal information about your baby, such as their full name, date of birth, and gender. Make sure to accurately fill in these details.
3. Provide contact information: In the form, you will need to provide your contact information, including your name, address, phone number, and email address. This allows the authorities to reach out to you if needed.
4. Specify any known hearing conditions: If your baby has any known hearing conditions or if you suspect that they may have a hearing impairment, make sure to mention it clearly on the form. This information helps healthcare professionals in providing the necessary care.
5. Indicate preferred language: Some hearing tests may be available in different languages. Indicate your preferred language on the form if applicable.
6. Sign and date the form: Finally, carefully review the form and ensure all information is accurately filled. Sign and date the form to validate your consent and understanding of the procedures involved.

Who needs a newborn hearing order form:

1. Parents and legal guardians: As a parent or legal guardian of a newborn, you will need a newborn hearing order form. This form allows you to grant permission for hearing tests to be conducted on your baby.
2. Healthcare professionals: The newborn hearing order form is also needed by healthcare professionals involved in conducting newborn hearing screening. It helps them obtain parental consent and gather essential information about the newborn's hearing health.
3. Hospitals and medical facilities: Hospitals and medical facilities use the newborn hearing order form to maintain records and ensure that proper screening and follow-up procedures are performed for newborns.

Remember, the specific requirements and availability of a newborn hearing order form may vary depending on your location and healthcare system. It's always best to consult with your healthcare provider for the most accurate and up-to-date information.

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