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STATE OF NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES Jeffrey A. Meyers Commissioner29 HAVEN DRIVE, CONCORD, NH 033016503 6032714225 18008523345 Ext. 4225 Fax: 6032714519 TDD Access: 18007352964Lisa
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How to fill out newborn hearing screening refusal
How to fill out newborn hearing screening refusal
01
To fill out a newborn hearing screening refusal form, follow these steps:
02
Obtain the newborn hearing screening refusal form from the healthcare provider or hospital.
03
Read the instructions on the form carefully to understand the information required.
04
Provide the necessary personal details of the newborn, such as name, date of birth, and gender.
05
Clearly state the reason for refusing the newborn hearing screening.
06
Sign and date the form, indicating your consent to the refusal.
07
Return the completed form to the healthcare provider or hospital, as instructed.
08
Keep a copy of the form for your records.
09
Please note that it is essential to consult with a healthcare professional before deciding to refuse newborn hearing screening, as it may have potential implications for the child's health and development.
Who needs newborn hearing screening refusal?
01
Newborn hearing screening refusal is typically needed by parents or legal guardians who have made an informed decision to decline the standard newborn hearing screening for their child.
02
It is important to note that newborn hearing screening is a widely recommended practice to identify hearing loss early and provide necessary interventions if required. However, parents or legal guardians may choose to refuse the screening for various reasons, such as personal beliefs, religious reasons, or prior medical advice.
03
Parents considering newborn hearing screening refusal are encouraged to consult with healthcare professionals to fully understand the potential risks and benefits and to explore alternative options for monitoring the child's hearing health.
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What is newborn hearing screening refusal?
Newborn hearing screening refusal is when a parent or guardian decides not to have their newborn baby undergo screening for hearing loss.
Who is required to file newborn hearing screening refusal?
The parent or guardian of the newborn baby is required to file newborn hearing screening refusal.
How to fill out newborn hearing screening refusal?
To fill out newborn hearing screening refusal, the parent or guardian must complete the necessary form provided by the healthcare provider or hospital.
What is the purpose of newborn hearing screening refusal?
The purpose of newborn hearing screening refusal is to document the decision of the parent or guardian to opt out of the hearing screening for their newborn baby.
What information must be reported on newborn hearing screening refusal?
The information that must be reported on newborn hearing screening refusal includes the name of the parent or guardian, the name of the newborn baby, and the reason for refusing the screening.
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