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Pediatric Hearing Screening Results Form
Directions: Use this form for early childhood or school aged hearing screenings. Provide
caregiver/s with a copy of this form, and keep a copy for your records.
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How to fill out pediatric hearing screening results
How to fill out pediatric hearing screening results
01
Collect all necessary materials including the audiometer, headphones, patient forms, and recording sheets.
02
Explain the procedure to the child's caregiver and ensure they understand the importance of accurate results.
03
Seat the child in a quiet room and ensure they are comfortable and relaxed.
04
Begin the screening by calibrating the audiometer and placing the headphones on the child.
05
Play a series of tones at varying frequencies and volumes, recording the child's responses on the appropriate form.
06
Based on the results, determine if further testing is required or if the child passes the screening.
07
Provide the caregiver with a copy of the results and discuss any necessary follow-up steps.
Who needs pediatric hearing screening results?
01
Pediatric patients
02
Children with suspected hearing loss
03
Children with a family history of hearing impairment
04
Children with developmental delays or speech/language delays
05
Children who have been exposed to ototoxic medications or noise
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What is pediatric hearing screening results?
Pediatric hearing screening results refer to the outcomes of a hearing test conducted on children to determine if they have any hearing impairment.
Who is required to file pediatric hearing screening results?
Healthcare providers and facilities that conduct pediatric hearing screenings are required to file the results.
How to fill out pediatric hearing screening results?
Pediatric hearing screening results can be filled out by documenting the test results, patient information, and other relevant details on the designated form.
What is the purpose of pediatric hearing screening results?
The purpose of pediatric hearing screening results is to identify any hearing issues in children at an early stage so that appropriate interventions can be initiated.
What information must be reported on pediatric hearing screening results?
Pediatric hearing screening results must include the test results, patient demographics, date of screening, and any follow-up recommendations.
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