1. What is your postal zip code?
2. What is your household income?
Under $15,000 per year
$15,000 to $25,000 per year
$25,000 to $50,000 per year
$50,000 to $75,000 per year
More than $75,000 per year
3. What is your child's gender ?
Female
Male
4. Current Age?
4. Age you learned of the hearing loss
years
months
5. What type of facility made the identification?
Pediatrician
Birth Hospital
Children's Hospital
Audiology Clinic
ENT Office
6. What type of testing was performed (check all that apply) Click the names for an explanation of the test, then close that window to return to the survey.
Automated
ABR
Click ABR
Threshold ABR
Otoacoustic Emissions
(OAE)
Behavioral Observation Audiometry
(BOA)
Visual Reinforcement Audiometry
(VRA)