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Hearing Health Screening
Permission Form
Child Health Worker: Bailey Fatwa
Phone: 4633 9500Please fill out all the information to enable your child to be screened
Child's Information
Full
Name:
D.O.B:Age:School:Gender:Is
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How to fill out hearing health screening permission
How to fill out hearing health screening permission
01
Step 1: Obtain the hearing health screening permission form from the relevant healthcare provider or organization.
02
Step 2: Read the instructions and requirements mentioned on the form carefully.
03
Step 3: Fill out your personal information accurately, including your name, address, contact information, and date of birth.
04
Step 4: Provide your consent to undergo the hearing health screening by signing and dating the form.
05
Step 5: If required, provide any additional information or medical history related to your hearing health.
06
Step 6: Review the completed form to ensure all the necessary details are filled out correctly.
07
Step 7: Submit the filled-out hearing health screening permission form to the designated healthcare provider or organization.
Who needs hearing health screening permission?
01
Anyone who wishes to have a hearing health screening conducted on themselves or on behalf of someone else may need to fill out a hearing health screening permission form.
02
This may apply to individuals of all ages, including children, adults, and seniors.
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