minnesota newborn screening program
Hearing Screening and Diagnostic Information for Audiologists
All diagnostic hearing evaluations need to be reported by an audiologist to MDH.
Signed, written consent from parents for submitting results to MDH is no longer necessary under the mandatory hearing screening law.
Timely report submission will streamline the follow-up process and assure that infants with confirmed hearing loss receive services as soon as possible.
There are two main ways to submit hearing screening results to MDH:
MDH Audiology Report Form (PREFERRED):
- You can report this information using the MDH Audiology Report form below:
- Hearing Reporting Form for Audiologists (PDF: 455KB/1 page)
- This form is interactive and can be completed on the computer or printed out and completed by hand.
- Completed forms should be faxed to: 651-215-6285.
Dictated Institutional Report:
- Diagnostic result and appointment information can also be reported to MDH simply by faxing your dictated report to MDH at 651-215-6285.
2012 NewslettersUpdated Monday, 27-Jan-2014 15:39:31 CST