Audiometric Screening

Attestation

Once you complete this survey, please allow 1-2 weeks for processing of your certification. Upon receiving your certificate, please maintain this, as part of your records, which will be reviewed during your clinics next site review.

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* I attest to having completed the following training: Audiometric. I understand staff being up to date with trainings will be reviewed during our clinics next scheduled site review and/or upon request.

Agree

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* Clinic Name

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* Clinic Address

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* Personal Information

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* (This will be the email where we send your certification)

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* I acknowledge it takes two (2) weeks to issue Certifications. If you have a Site Review in the next two weeks, please notify FSR@partnershiphp.org and we will try our best to expedite this process for you.

Agree