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Get the free Utah Newborn Hearing Screening & CCHD Weekly Reporting Form - health utah

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Rev 6/25/2018Utah Newborn Hearing Screening & CCD Weekly Reporting Form Please print clearly and fill out all that applyMidwifeScreenerBaby Info Baby Name:Mom Info Moms Name:Baby DOB:Moms DOB:Gender:Phone:Blood
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How to fill out utah newborn hearing screening

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How to fill out utah newborn hearing screening

01
Obtain the necessary forms: You will need to get the Utah Newborn Hearing Screening form, which can typically be obtained from the hospital or birthing center where your baby was born.
02
Fill out the personal information: On the form, you will be required to provide personal information such as the baby's full name, date of birth, and address. Make sure to double-check the accuracy of this information.
03
Complete the medical history section: The form may ask for details about the baby's medical history, including any known hearing impairments in the family. Answer all the questions accurately.
04
Sign and date the form: At the end of the form, you will need to sign and date it, confirming that the information provided is true and accurate.
05
Submit the form: Once you have filled out the form completely, submit it as instructed by the hospital or relevant healthcare authority. They may provide a drop-off location or a mailing address for this purpose.
06
Follow up if required: In some cases, you may be asked to follow up with additional steps, such as scheduling an appointment for the hearing screening. Be sure to adhere to these instructions to ensure your baby's hearing health is properly assessed.

Who needs utah newborn hearing screening?

01
All newborn babies in Utah are required to undergo hearing screening.
02
This includes babies who were born in a hospital, birthing center, or at home with the assistance of a certified midwife or healthcare professional.
03
The purpose of the screening is to identify any potential hearing loss as early as possible, so that appropriate intervention and support can be provided to the baby and their family.
04
It is important to note that this screening is mandatory and is not limited to babies with known risk factors for hearing loss. All babies, regardless of their perceived risk, need to undergo the screening to ensure early detection and intervention if necessary.
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Utah newborn hearing screening is a mandatory screening conducted on all newborns to detect any potential hearing loss.
Healthcare providers are required to file Utah newborn hearing screening for each newborn baby.
Healthcare providers can fill out Utah newborn hearing screening forms electronically or manually with the required information.
The purpose of Utah newborn hearing screening is to identify any hearing loss early on in newborns so that appropriate interventions can be initiated.
Information such as the baby's name, date of birth, test results, and any follow-up recommendations must be reported on Utah newborn hearing screening.
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