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Hearing Monitoring


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Any requests for hearing assessment associated with ototoxic treatment
  • Category 2
    (appointment within 90 calendar days)
    • No Category 2 criteria
  • Category 3
    (appointment within 365 calendar days)
    • Children who have been identified as having risk factors for acquired hearing loss through the Healthy Hearing Targeted Surveillance Program (List)
    • Children with hearing loss who are unaided

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Reason why hearing test is being requested

3. Additional referral information Useful for processing the referral

  • Details of current or previous treatments with ototoxic pharmaceutical agents:
    • Aminoglycoside and chemotherapeutic agents can cause permanent bilateral SNHL
    • Loop diuretics, salicylates, and antimalarial agents usually cause temporary bilateral SNHL that returns to normal soon after pharmacological therapy is stopped
  • Details of any change in hearing levels post commencement of pharmaceutical treatment if applicable
  • Details of any otologic symptoms or pre-existing hearing loss if applicable.
  • Any previous hearing screening or assessments if applicable
  • ENT history if applicable
  • Neurology/neurosurgery history if applicable
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Details of any trauma
  • The person's hearing and communication needs at home, or in education, and in social situations

4. Request

Last updated: 13 June 2023