Get the free California Newborn Hearing Screening Program Outpatient Screening Reporting Form

Name: Fillable Online California Newborn Hearing Screening Program Outpatient Screening Reporting Form Fax Email Print - pdfFiller
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California Newborn Hearing Screening ProgramOutpatient Screening Reporting Formulas complete this form and Fax to (800) 8661074 or Mail to the Northern California Hearing Coordination Center, 1501

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How to fill out california newborn hearing screening

01

Step 1: Obtain the newborn hearing screening form from the hospital or birthing center.

02

Step 2: Fill out the form properly with accurate information about the newborn.

03

Step 3: Provide information about the newborn's birth history, including any complications or risk factors.

04

Step 4: Complete the parent/guardian section of the form with your contact information.

05

Step 5: Sign the form to authorize the hearing screening.

06

Step 6: Submit the completed form to the designated healthcare professional or department for further processing.

Who needs california newborn hearing screening?

01

All newborn babies in California are required to undergo newborn hearing screening.

02

This includes infants born in hospitals, birthing centers, or at home.

03

The screening is essential to identify any hearing loss or potential hearing problems early on.

04

It allows for timely intervention and appropriate support to ensure optimal auditory development for the newborn.

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What is california newborn hearing screening?

California newborn hearing screening is a program that identifies babies who may have hearing loss soon after birth.

Who is required to file california newborn hearing screening?

Hospitals and birth centers are required to file California newborn hearing screening.

How to fill out california newborn hearing screening?

California newborn hearing screening can be filled out online or through paper forms provided by the hospital or birth center.

What is the purpose of california newborn hearing screening?

The purpose of California newborn hearing screening is to ensure early detection and intervention for babies with hearing loss.

What information must be reported on california newborn hearing screening?

Information such as baby's name, date of birth, screening results, and contact information must be reported on California newborn hearing screening.

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