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Name: Grade: Teacher: Date:HEARING SCREENING RECORDFrequency1000 2000 4000Right Ear Left Ear×Indicates: Failure at prescribed screening level×Indicates: Failure by a second screenerSCREENING RESULTS
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How to fill out hearing screening record template

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How to fill out hearing screening record

01
To fill out a hearing screening record, follow these steps:
02
Start by noting down the date of the screening at the top of the record.
03
Write down the name and age of the individual being screened.
04
Fill in any necessary demographic information such as the individual's address, contact details, and identification number.
05
Record the screening results for each ear separately. This includes noting the type of hearing test performed (e.g., pure-tone audiometry, otoacoustic emissions), the equipment used, and the specific frequencies or tones tested.
06
Write down the measured thresholds or responses obtained for each ear at the respective frequencies.
07
If any abnormalities or concerns are observed during the screening, make sure to provide any relevant comments or observations.
08
Finally, sign and date the hearing screening record to indicate the completion of the screening process.
09
Note: It is important to use clear and legible handwriting to ensure accurate record-keeping.

Who needs hearing screening record?

01
Hearing screening records are typically needed for individuals who require or undergo hearing tests. This includes:
02
- Infants and children as part of routine pediatric care or to monitor developmental milestones
03
- Students in educational settings to assess their hearing abilities
04
- Employees in certain occupations where accurate hearing is essential (e.g., pilots, air traffic controllers)
05
- Individuals with suspected hearing loss or those receiving audiological evaluations
06
- Patients in healthcare facilities or clinics as part of their overall health assessment
07
Ultimately, any individual who wants to maintain a record of their hearing health can benefit from having a hearing screening record.

What is HEARING SCREENING RECORD Form?

The HEARING SCREENING RECORD is a Word document required to be submitted to the relevant address in order to provide certain info. It must be completed and signed, which may be done in hard copy, or with the help of a particular software e. g. PDFfiller. This tool lets you fill out any PDF or Word document directly from your browser (no software requred), customize it according to your needs and put a legally-binding electronic signature. Right away after completion, you can send the HEARING SCREENING RECORD to the relevant receiver, or multiple individuals via email or fax. The template is printable too from PDFfiller feature and options presented for printing out adjustment. In both digital and physical appearance, your form will have a neat and professional appearance. It's also possible to save it as the template for later, there's no need to create a new blank form from the beginning. Just customize the ready document.

Template HEARING SCREENING RECORD instructions

Before filling out HEARING SCREENING RECORD MS Word form, remember to prepared all the information required. It's a very important part, because typos can trigger unpleasant consequences beginning from re-submission of the whole and filling out with deadlines missed and even penalties. You have to be especially careful filling out the figures. At first sight, this task seems to be not challenging thing. Yet, you might well make a mistake. Some use such lifehack as saving everything in a separate document or a record book and then add this into documents' temlates. In either case, try to make all efforts and provide valid and solid info in your HEARING SCREENING RECORD word template, and doublecheck it when filling out the required fields. If it appears that some mistakes still persist, you can easily make some more amends while using PDFfiller editor and avoid missing deadlines.

How to fill HEARING SCREENING RECORD word template

The very first thing you need to start completing HEARING SCREENING RECORD writable doc form is editable copy. If you complete and file it with the help of PDFfiller, see the options down below how to get it:

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Regardless of the option you prefer, you'll be able to edit the form and add different nice things in it. Except for, if you want a word form containing all fillable fields, you can obtain it only from the filebase. Other options are short of this feature, so you will need to insert fields yourself. Nevertheless, it is quite easy and fast to do as well. Once you finish this procedure, you'll have a convenient document to fill out or send to another person by email. The fields are easy to put whenever you need them in the word file and can be deleted in one click. Each purpose of the fields matches a certain type: for text, for date, for checkmarks. If you want other persons to put signatures in it, there is a signature field too. Signing tool enables you to put your own autograph. When everything is ready, hit Done. And then, you can share your word template.

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Hearing screening record is a document that records the results of a hearing screening test to assess an individual's hearing ability.
Employers are required to file hearing screening record for their employees who are exposed to noise in the workplace.
Hearing screening record should be filled out by a qualified healthcare professional who conducts the hearing screening test.
The purpose of hearing screening record is to track and monitor the hearing health of individuals exposed to noise in the workplace.
Hearing screening record must include the individual's name, date of screening, results of the screening test, and any recommendations for further evaluation or protection.
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