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Physician Form to Fax Results of Outpatient Hearing Screen or Diagnostic Audiological Evaluation to State Newborn Hearing Screening Program - New Mexico
Physician Form to Fax Results of Outpatient Hearing Screen or Diagnostic Audiological Evaluation to State Newborn Hearing Screening Program is a legal document that was released by the New Mexico Department of Health - a government authority operating within New Mexico.
FAQ
Q: What is the purpose of the Physician Form?
A: The purpose of the Physician Form is to fax the results of an outpatient hearing screen or diagnostic audiological evaluation to the State Newborn Hearing Screening Program in New Mexico.
Q: When should the Physician Form be used?
A: The Physician Form should be used when faxing the results of an outpatient hearing screen or diagnostic audiological evaluation to the State Newborn Hearing Screening Program in New Mexico.
Q: Which program in New Mexico does the Physician Form need to be faxed to?
A: The Physician Form needs to be faxed to the State Newborn Hearing Screening Program in New Mexico.
Q: What type of hearing screenings or evaluations can be faxed using the Physician Form?
A: The Physician Form can be used to fax the results of outpatient hearing screens or diagnostic audiological evaluations.
Q: Is the Physician Form specific to New Mexico?
A: Yes, the Physician Form is specific to the State Newborn Hearing Screening Program in New Mexico.
Form Details:
- Released on August 1, 2013;
- The latest edition currently provided by the New Mexico Department of Health;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Mexico Department of Health.
