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Family Enrollment Form Family Name: Name of Child with Hearing Loss: Birthdate: Age at Diagnosis: Birthing Hospital: Newborn Hearing Screening: Child's Hearing loss is categorized as: Conductive Mild
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Newborn screening information is for identifying any potential health issues or conditions in newborn babies.
Healthcare providers or hospitals are required to file newborn screening information for each newborn baby.
Newborn screening information can be filled out by healthcare providers using the designated forms or electronic systems provided by the relevant authorities.
The purpose of newborn screening information is to ensure early detection and intervention for any health issues or conditions in newborn babies.
Information such as blood tests results, hearing tests results, and any other relevant health assessments must be reported on newborn screening information.
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