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Chalet Regional Hospital 1750 Sunset Drive Bathurst, NB E2A 4L7 18886959222 (extension 3869× 5065443869 Cochlear Implant Candidacy Referral Form New Brunswick Cochlear Implant Followup Services Name:

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How to fill out cochlear implant candidacy referral

How to fill out a cochlear implant candidacy referral:

01

Start by gathering all necessary information: The first step in filling out a cochlear implant candidacy referral is to gather all necessary information. This includes the patient's personal information such as their name, date of birth, contact details, and relevant medical history.

02

Provide a detailed medical history: It is important to provide a detailed medical history for the patient. This may include information regarding their hearing loss, any previous treatments or interventions, and any other relevant medical conditions.

03

Include audiological assessments: In order to determine the candidacy for a cochlear implant, it is crucial to include audiological assessments. This may involve providing recent audiograms, speech perception tests, and other hearing tests that demonstrate the severity of the patient's hearing loss.

04

Submit medical reports: Medical reports from ENT (Ear, Nose, and Throat) doctors or audiologists are often required in a candidacy referral. These reports should provide a comprehensive evaluation of the patient's hearing health, including any previous treatments, hearing aids worn, and the effectiveness of those devices.

05

Describe the impact of hearing loss: It is important to describe the impact of hearing loss on the patient's daily life. This can include difficulties in communication, social interactions, educational or occupational performance, and overall quality of life. Providing specific examples can help convey the extent of the patient's hearing loss and the potential benefits of a cochlear implant.

Who needs a cochlear implant candidacy referral?

Cochlear implant candidacy referrals are typically required for individuals with severe to profound sensorineural hearing loss who may benefit from a cochlear implant. This referral is necessary for individuals who have already tried traditional hearing aids but have not achieved sufficient benefit. Candidates for a cochlear implant may include adults and children of various age groups.

It is important to consult with an ENT specialist or audiologist to determine if a cochlear implant candidacy referral is necessary for a particular individual. The referral serves as an initial step in the evaluation process and helps ensure that the appropriate candidates receive further assessment and consideration for cochlear implantation.

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What is cochlear implant candidacy referral?

Cochlear implant candidacy referral is a formal process by which individuals are referred for evaluation to determine their eligibility for a cochlear implant.

Who is required to file cochlear implant candidacy referral?

Typically, cochlear implant candidacy referral is filed by audiologists, ENT specialists, or speech-language pathologists.

How to fill out cochlear implant candidacy referral?

Cochlear implant candidacy referral forms can usually be completed online or submitted in person at a medical facility specializing in cochlear implants.

What is the purpose of cochlear implant candidacy referral?

The purpose of cochlear implant candidacy referral is to assess whether a person is a suitable candidate for a cochlear implant, based on their hearing loss severity and other medical factors.

What information must be reported on cochlear implant candidacy referral?

Cochlear implant candidacy referral forms typically require information such as the patient's medical history, hearing test results, and any relevant medical diagnoses.

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