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TMC Migrant and Seasonal Head Start HEARING SCREEN RECORD Child: DOB: Center: The information entered on this form is a record of screening results and is not to be used for diagnostic purposes. Pass
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Who needs hearing screen record?

01
Audiologists and other healthcare professionals who perform hearing screenings need to keep accurate records of their patients' results.
02
Schools and educational institutions may also require hearing screen records for students, especially those who receive special education services or accommodations.
03
Employers in certain industries, such as manufacturing or aviation, may need to maintain hearing screen records as part of workplace safety protocols.

How to fill out a hearing screen record:

01
Start by gathering the necessary information, such as the patient's full name, date of birth, contact details, and any relevant medical history.
02
Record the date and location of the hearing screening, as well as the name and credentials of the person conducting the test.
03
Note the specific tests or procedures used during the screening, such as pure-tone audiometry or otoacoustic emissions testing.
04
Document the results of each test, including the patient's hearing thresholds at different frequencies, any abnormalities or concerns, and recommendations for follow-up.
05
If the hearing screening identifies a possible hearing loss, make a note of any referrals made to specialists, such as an audiologist or otolaryngologist.
06
Ensure that the form is signed and dated by the healthcare professional conducting the screening, certifying the accuracy of the record.
07
Keep the completed hearing screen record in a secure and confidential file, accessible only to authorized individuals who require the information for medical or legal purposes.
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Hearing screen record is a documentation of the results of hearing screening tests conducted on individuals to assess their hearing abilities.
Healthcare professionals and organizations responsible for conducting hearing screenings are required to file hearing screen records.
Hearing screen records should be filled out with detailed information about the individual being tested, the results of the screening tests, and any follow-up recommendations.
The purpose of hearing screen record is to track and monitor the hearing health of individuals, identify any potential hearing issues early on, and make necessary interventions.
Information such as the individual's name, date of birth, date of screening, screening results, and any recommendations for follow-up care must be reported on hearing screen records.
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