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Hearing Screening Questionnaire Child Screening at 4, 5, 6, 8, and 10 years old Today's date: ___ Patient Name: ___ Date of Birth: ___ 1. Was your child exposed to infection before birth? YesNo2.

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How to fill out your babys hearing screening

01

Schedule an appointment with a healthcare provider to have your baby's hearing screened.

02

Prepare any necessary documents or identification for the appointment.

03

Bring your baby to the appointment at the scheduled time.

04

Follow any instructions given by the healthcare provider to ensure an accurate screening.

05

Wait for the results of the screening and discuss them with the healthcare provider.

Who needs your babys hearing screening?

01

All newborn babies should have their hearing screened within the first few weeks of life to ensure early detection of any hearing impairments.

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What is your babys hearing screening?

Your baby's hearing screening is a test that checks for hearing loss in newborns.

Who is required to file your babys hearing screening?

Medical professionals such as pediatricians or audiologists are typically responsible for conducting and filing your baby's hearing screening.

How to fill out your babys hearing screening?

The hearing screening is usually done shortly after birth and involves placing a small device in your baby's ear to measure their response to sound.

What is the purpose of your babys hearing screening?

The purpose of the hearing screening is to detect any potential hearing loss early on so that interventions can be started as soon as possible.

What information must be reported on your babys hearing screening?

The hearing screening results, any follow-up recommendations, and the date the screening was conducted must be reported on your baby's hearing screening.

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