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(MC1) Welcome to Medicare (IPPE) (MC2) Initial Wellness (MC3) Subsequent WellnessHEARING SCREEN Form # 313 (8/16)Name: ___Date: ___DOB: ___Ten Ways To Recognize Hearing Loss The following questions

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How to fill out 313 - hearing screen

01

Step 1: Gather the necessary materials, including form 313 and writing instruments.

02

Step 2: Enter the patient's personal information at the top of the form, including name, date of birth, and contact details.

03

Step 3: Record relevant medical history and any prior hearing issues or treatments.

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Step 4: Indicate the reason for the hearing screen, specifying whether it is routine or due to specific complaints.

05

Step 5: Complete the sections tracking the patient's current medications, allergies, and any other relevant health factors.

06

Step 6: Document the results of the hearing tests conducted, including audiometry and other assessments.

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Step 7: Note any referrals or follow-ups recommended based on the screening outcomes.

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Step 8: Ensure all signatures are obtained, including the clinician's and, if applicable, the patient's guardian.

Who needs 313 - hearing screen?

01

Children undergoing routine developmental assessments.

02

Adults experiencing difficulties with hearing.

03

Patients with a history of ear infections or other auditory issues.

04

Individuals in occupations with high noise exposure.

05

Residents in long-term care facilities for regular health monitoring.

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What is 313 - hearing screen?

The 313 - hearing screen is a document used to report the results of hearing screenings conducted to assess the hearing abilities of individuals, particularly in educational or clinical settings.

Who is required to file 313 - hearing screen?

Health professionals, such as audiologists or school health personnel, who conduct hearing screenings on children or individuals in educational settings are required to file the 313 - hearing screen.

How to fill out 313 - hearing screen?

To fill out the 313 - hearing screen, the individual conducting the screening needs to enter the participant's information, record the screening results, and provide any additional comments or recommendations based on the findings.

What is the purpose of 313 - hearing screen?

The purpose of the 313 - hearing screen is to identify individuals who may have hearing impairments and to facilitate early intervention and appropriate referrals for further evaluation and support.

What information must be reported on 313 - hearing screen?

The information that must be reported on the 313 - hearing screen includes the individual’s identifying information, the results of the hearing test, any significant observations, and recommendations for follow-up if necessary.

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