Audiologists

Protocols for Diagnostic Audiological Assessment

Information for Parents of Children with Hearing Loss, Virginia's Resource Guide for Parents


Información para padres de niños con pérdida auditiva, Guía de Recursos de Virginia para padres

Screening/Audiological Reporting Form

This form is to be used for reporting results of hearing screening (post hospital discharge), diagnostic audiologic assessment, recommendations and referrals on infants and young children to the Virginia Early Hearing Detection and Intervention Program as required by the Code of Virginia.
Return by mail to address on form or via fax to (804) 864-7721 within 2 weeks of child’s visit.

Screening/Audiological Reporting Form Instructions

Practitioner/Facility Registration Form
Submit this form to apply to be an approved provider of diagnostic audiological services under the Early Hearing Detection and Intervention Program.