Get the free Newborn Hearing Screening Report - idph state il

State of Illinois Department of Public Health Early Hearing Detection and Intervention Newborn Hearing Screening Report Child's Name Med. ID Other names this infant may also be known as: Date of Birth

How to fill out newborn hearing screening report

How to fill out newborn hearing screening report:

1. Gather all necessary information: This includes the baby's full name, date of birth, weight, and any other relevant demographic information. Make sure to double-check that all information is accurate.
2. Document the test results: Include the results of both Otoacoustic Emission (OAE) and Auditory Brainstem Response (ABR) tests. Fill in the appropriate sections with the outcome of each test.
3. Note any abnormal findings: If there are any abnormalities or concerns identified during the screening, make sure to indicate them clearly in the report. Provide a detailed description of the specific issue or issue.
4. Record any additional notes: Include any additional observations or relevant information that may be beneficial for further evaluation or follow-up.
5. Sign and date the report: Ensure that the report is signed and dated by the individual conducting the screening. This adds validity and accountability to the document.

Who needs newborn hearing screening report?

1. Parents and guardians: The primary individuals who need the newborn hearing screening report are the parents or guardians of the newborn. This report provides them with crucial information about their baby's hearing health and any potential concerns.
2. Pediatricians and healthcare professionals: Newborn hearing screening reports are also essential for pediatricians and healthcare professionals who are involved in the care of the infant. These reports help in monitoring and addressing any hearing-related issues early on.
3. Audiologists and specialists: Audiologists and other specialists rely on newborn hearing screening reports to further evaluate any concerns identified during the initial screening. These reports contribute to the development of appropriate treatment plans or intervention strategies if needed.

In summary, filling out a newborn hearing screening report involves accurately documenting the test results, noting any abnormalities, including additional observations, signing the report, and dating it. The report is primarily required by parents and guardians, pediatricians and healthcare professionals, and audiologists/specialists for effective monitoring and follow-up of the infant's hearing health.

For pdfFiller’s FAQs

What is newborn hearing screening report?

Newborn hearing screening report is a report that evaluates the hearing ability of newborn babies shortly after birth.

Who is required to file newborn hearing screening report?

Healthcare providers or hospitals are usually required to file newborn hearing screening reports.

How to fill out newborn hearing screening report?

Newborn hearing screening reports are typically filled out by healthcare professionals using specific forms provided by the relevant authorities.

What is the purpose of newborn hearing screening report?

The purpose of newborn hearing screening report is to detect hearing loss in newborn babies early on so that interventions can be initiated promptly.

What information must be reported on newborn hearing screening report?

The information typically reported on newborn hearing screening report includes the date of the screening, the name and details of the baby, and the test results.

How can I modify newborn hearing screening report without leaving Google Drive?

You can quickly improve your document management and form preparation by integrating pdfFiller with Google Docs so that you can create, edit and sign documents directly from your Google Drive. The add-on enables you to transform your newborn hearing screening report into a dynamic fillable form that you can manage and eSign from any internet-connected device.

How can I send newborn hearing screening report for eSignature?

To distribute your newborn hearing screening report, simply send it to others and receive the eSigned document back instantly. Post or email a PDF that you've notarized online. Doing so requires never leaving your account.

How do I make edits in newborn hearing screening report without leaving Chrome?

Adding the pdfFiller Google Chrome Extension to your web browser will allow you to start editing newborn hearing screening report and other documents right away when you search for them on a Google page. People who use Chrome can use the service to make changes to their files while they are on the Chrome browser. pdfFiller lets you make fillable documents and make changes to existing PDFs from any internet-connected device.