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MOLECULAR GENETICS LABORATORYKejian Zhang, M.D., M.B.A., Director courier service and/or inquiries, please contact 5136364474 Fax: 51363643733333 Burned Avenue, Room NRL 1013www.cincinnatichildrens.org/moleculargenetics
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How to fill out hearing loss test requisition

01
Obtain a hearing loss test requisition form from your healthcare provider.
02
Fill out your personal information including name, date of birth, contact information, and insurance details.
03
Provide details about your symptoms and any relevant medical history.
04
Ensure the form is complete and accurate before submitting it to the testing facility.
05
Wait for confirmation of your appointment for the hearing loss test.

Who needs hearing loss test requisition?

01
Individuals who are experiencing symptoms of hearing loss such as difficulty hearing conversations, ringing in the ears, or trouble hearing high-pitched sounds.
02
Individuals who have been referred by their healthcare provider for a hearing loss evaluation.
03
Individuals who are required to undergo a hearing loss test for work or school purposes.
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Hearing loss test requisition is a form or request submitted to authorize and schedule a hearing test for an individual.
Employers are usually required to file the hearing loss test requisition on behalf of their employees.
Hearing loss test requisition can be filled out by providing the necessary information about the employee, employer, and other relevant details.
The purpose of hearing loss test requisition is to assess the hearing health of individuals, especially those exposed to noise in the workplace.
Information such as employee's name, date of birth, job title, date of hire, and exposure to noise levels must be reported on the hearing loss test requisition.
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