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State of California Health and Human Services AgencyDepartment of Health Care Services Systems of Rehearing SCREENING REQUEST WAIVER School Year CDS code numberSchool districtAddress (number and street)City
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How to fill out hearing screening request waiver

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How to fill out hearing screening request waiver

01
To fill out a hearing screening request waiver, follow these steps:
02
Obtain the waiver form from the appropriate authority or organization.
03
Read the instructions carefully before filling out the form.
04
Provide your personal information such as name, address, contact details, etc.
05
Fill in the relevant sections pertaining to the reason for the waiver request.
06
Provide any supporting documentation, if required.
07
Review the completed form to ensure all information is accurate and complete.
08
Sign and date the form.
09
Submit the filled-out form to the designated authority or organization through the specified submission method.
10
Keep a copy of the filled-out form for your records.

Who needs hearing screening request waiver?

01
Anyone who requires a waiver for the hearing screening is eligible to fill out the hearing screening request waiver. This may include individuals who have a medical condition that prevents them from undergoing the screening, individuals with a religious or personal objection to the screening, or individuals who have already undergone a recent hearing test and can provide the necessary documentation as proof.
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A hearing screening request waiver is a form used to exempt individuals from the mandatory hearing screening requirements.
Individuals who qualify for an exemption from hearing screening requirements are required to file a hearing screening request waiver.
The hearing screening request waiver form can be filled out by providing personal information, reasons for exemption, and any supporting documents.
The purpose of the hearing screening request waiver is to allow individuals to request an exemption from mandatory hearing screening based on valid reasons.
The hearing screening request waiver requires personal information, reasons for exemption, and any supporting documents to be reported.
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