Hearing screening report example 2026

1. Click ‘Get Form’ to open the hearing screening report example in the editor.
2. Begin by filling in the child's name and date of birth at the top of the form. Ensure accuracy for proper record-keeping.
3. Next, indicate the location of the screening and the date of the test. This information is crucial for tracking and follow-up.
4. In the Visual Inspection section, check 'Yes' or 'No' regarding ventilation tubes. If applicable, specify which ear(s) are affected.
5. For Tympanometry/Impedance Screening, enter physical volume and compliance details for both ears. Mark 'Pass' or 'Refer' as appropriate.
6. Proceed to Otoacoustic Emissions Screening and select 'Pass' or 'Refer'.
7. Complete Pure Tone Threshold Screening by entering results for each frequency tested in both ears, marking 'Pass' or 'Refer'.
8. Finally, provide recommendations based on findings, including any necessary referrals. Add comments if needed.

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