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THE GEORGE WASHINGTON UNIVERSITY SPEECH AND HEARING CENTER Cochlear Implant Case History Form Audiology Name Sex Date of Birth Age Phone (cell) Address Apt. # Phone (home) City State Zip Phone (work)
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How to fill out impact of a cochlear
How to fill out impact of a cochlear
01
Begin by gathering all necessary information about the person receiving the impact of a cochlear.
02
Ensure that you have the correct documentation and forms to fill out.
03
Start by entering the personal information of the individual, including their full name, date of birth, and contact details.
04
Provide information about the type of cochlear implant being used, including the make and model.
05
Clearly state the purpose or reason for needing the impact of a cochlear, such as hearing impairment or deafness.
06
Describe the expected outcomes or benefits of the cochlear implant, including improvement in hearing and quality of life.
07
Include any relevant medical history or previous treatments for hearing loss.
08
Indicate any additional support or services required for the person receiving the cochlear implant, such as speech therapy or counseling.
09
Review the completed form for accuracy and completeness before submission.
10
Submit the filled-out impact of a cochlear form to the appropriate authorities or healthcare professionals.
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Follow up with any additional documentation or information as requested.
Who needs impact of a cochlear?
01
Individuals who have a significant hearing impairment or deafness may need the impact of a cochlear.
02
This can include people of all ages, from children to adults.
03
Those who have exhausted other forms of hearing assistance or treatment options may also require a cochlear implant.
04
It is important to consult with a medical professional or audiologist to determine if a cochlear implant is the right choice for an individual.
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