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Get Mn School Hearing Screening Worksheet 2018-2024

En date Rescreen date Any parent/teacher/child concerns about hearing? Visual Inspection External inspection Internal inspection/otoscopy (if Initial screen PASS/REFER PASS/REFER Rescreen PASS/REFER PASS/REFER done) If REFER, please describe findings: Pure tone audiometry Right ear 500 Hz, 25 dB 1000 Hz, 20 dB 2000 Hz, 20 dB 4000 Hz, 2.

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