Hearing screening form 2025

Get Form
hearing screening form Preview on Page 1

Here's how it works

01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

The best way to edit Hearing screening form online

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2

With DocHub, making adjustments to your paperwork requires only a few simple clicks. Follow these fast steps to edit the PDF Hearing screening form online free of charge:

  1. Sign up and log in to your account. Sign in to the editor using your credentials or click on Create free account to test the tool’s capabilities.
  2. Add the Hearing screening form for redacting. Click the New Document option above, then drag and drop the file to the upload area, import it from the cloud, or using a link.
  3. Adjust your document. Make any adjustments required: add text and pictures to your Hearing screening form, underline details that matter, erase parts of content and replace them with new ones, and insert icons, checkmarks, and areas for filling out.
  4. Finish redacting the form. Save the modified document on your device, export it to the cloud, print it right from the editor, or share it with all the parties involved.

Our editor is super intuitive and efficient. Try it now!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
A hearing screening is a quick test that you will pass or fail. If you pass, then you show no signs of hearing loss. If you fail, you will need more in-depth hearing testing. You should see someone trained to do hearing screenings, like an audiologist, nurse, or teacher.
Fill in the patients personal information such as name, age, and contact details at the top of the form. Indicate the date of the screening on the designated line. Provide information regarding the patients medical history, particularly any previous hearing issues.
For each ear, note the results of the pure tone hearing screening and tympanometry (if performed). Document each frequency screened in a manner that indicates the decibel it was screened at and whether the result was a PASS or REFER.
Children get screenings at school or at the doctors office. Adults can go to the doctor or local health fairs for a screening. You should ask your doctor for a hearing screening if you have concerns about your or your childs hearing. An audiologist can give you a more complete hearing test if you fail the screening.
Recommended Early Hearing Detection and Intervention (EHDI) benchmarks include screening for hearing loss before 1 month of age, diagnostic evaluation before 3 months of age, and enrollment in early intervention before 6 months of age, known as the 1-3-6 benchmarks.
be ready to get more

Complete this form in 5 minutes or less

Get form

People also ask

It depends upon insurance, but most people can get a hearing test without a referral from their primary care doctor. If audiologists feel like an ENT is needed, then they place the referral.
Lots of large pharmacies and opticians have hearing specialists (audiologists) who can do hearing tests for adults aged 18 and over. The test is often free, but you may have to pay for any treatment you might need (such as hearing aids).

Related links