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N E W B O R N H E A R I N G S C R E E N I N G 2026

N E W B O R N H E A R I N G S C R E E N I N G Preview on Page 1

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The document is an Infant Reporting Form for Newborn Hearing Screening, detailing the procedures and results of hearing tests conducted on infants. It includes sections for recording screening types (ABR, DPOAE, TEOAE), results (pass or refer), follow-up actions, and parent/guardian information. The form aims to ensure proper documentation and follow-up for infants who may have hearing impairments.

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Click ‘Get Form’ to open the N E W B O R N H E A R I N G S C R E E N I N G in the editor.
Begin by filling out the 'Infant Reporting' section. Enter the date of screening and select the type of screening performed (ABR, DPOAE, TEOAE) for both right and left ears.
Indicate the results for each ear by checking either 'PASS' or 'REFER'. If applicable, provide details regarding any follow-up actions taken.
Complete the 'Follow-Up for Refers/Missed' section. Verify and update parent/legal guardian information, including primary language and contact details.
Fill in the infant's full/legal name and check if the NHSP brochure was given to the parent. Document any follow-up appointments made.
Finally, ensure all sections are completed accurately before saving your document. You can easily share or print it directly from our platform.

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Versions	Form popularity	Fillable & printable
2016	4.5 Satisfied (24 Votes)
2010	4.7 Satisfied (58 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are three signs of a babys hearing problem?

Baby does not turn toward a sound after age six months. Baby turns his or her head when they see you but does not turn if you only call his or her name. Baby seems to hear some sounds and not others. Babys babbling does do not evolve and is not saying single words such as dad or mama by one year of age.

When to worry about newborn hearing?

It is recommended that all babies are screened for hearing loss no later than 1 month of age. If a baby does not pass the hearing screening, it is important that they get a diagnostic hearing test and evaluation by a hearing specialist as soon as possible, by no later than 3 months of age.

How do I know if my babys hearing is ok?

Otoacoustic emissions (OAE) tests whether some parts of the ear respond to sound. During this test, a soft earphone is inserted into your babys ear canal. It plays sounds and measures an echo response that occurs in ears with normal hearing. If there is no echo, your baby might have hearing loss.

When should I worry about my newborns hearing?

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.