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Thank you for making your appointment with The Speech & Hearing Center. Enclosed in this packet is all of your initial paperwork, along with directions to our location. Please complete the enclosed

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How to fill out newborn-hearing-intake-packet

01

Obtain the newborn-hearing-intake-packet from the healthcare provider or hospital.

02

Fill out the baby’s personal information such as name, date of birth, and address.

03

Provide the mother's prenatal history and any complications during pregnancy.

04

Include information about the baby's birth, including weight, length, and any complications during delivery.

05

Add details about the baby's health and any known medical conditions.

06

Sign and date the intake packet to confirm all information is accurate.

Who needs newborn-hearing-intake-packet?

01

Parents of a newborn baby who want to have their child's hearing tested.

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What is newborn-hearing-intake-packet?

The newborn-hearing-intake-packet is a form used to collect essential information regarding the hearing screening of newborns.

Who is required to file newborn-hearing-intake-packet?

Healthcare providers who perform hearing screenings on newborns are required to file the newborn-hearing-intake-packet.

How to fill out newborn-hearing-intake-packet?

To fill out the newborn-hearing-intake-packet, providers should complete all sections with accurate data about the newborn, including demographic information and results of the hearing tests.

What is the purpose of newborn-hearing-intake-packet?

The purpose of the newborn-hearing-intake-packet is to ensure that all newborns are screened for hearing loss and to record the results for further action if necessary.

What information must be reported on newborn-hearing-intake-packet?

The packet must report information such as the newborn's name, date of birth, hearing screening results, and any follow-up recommendations.

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