Source | csiro.fhir.au.smartforms#current:Smart Forms (v4.0.1) |
resourceType | Questionnaire |
id | EarHealthAndHearing |
canonical | http://www.health.gov.au/assessments/mbs/715/EarHealthAndHearing |
version | 0.1.0 |
status | draft |
publisher | AEHRC CSIRO |
name | EarHealthAndHearing |
title | Aboriginal and Torres Strait Islander Health Check - Ear Health And Hearing |
date | 2022-05-24 |
experimental | false |
description | Ear Health And Hearing sub-questionnaire for Aboriginal and Torres Strait Islander Health Check. |
copyright | CSIRO © 2022+; Licensed under Apache License, Version 2.0 |
jurisdictions | au |
Usages | (none) |
Ear health and hearing
In progress
Complete
Child listening concerns
Is there anything that you are worried about with your child's listening?
Details
Child language concerns
Is there anything you are worried about with your child's language/talking?
Details
Child snoring
Do you notice snoring/noisy breathing at night/while your child is sleeping?
Details
Hearing concerns
Is there anything that you are worried about with your hearing?
Details
Last hearing test (audiology)
Ear examination
Otoscopy
Video otoscopy procedure recommended where possible as it allows for parental education and for images to be saved for tracking over time
Otoscopy findings
Left ear
Right ear
Otoscopy findings
Left ear
Right ear
Tympanometry
Left ear
Right ear
Health priorities, actions and follow-up
Mark section as complete
Produced 08 Sep 2023