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Autorización y Cuestionario para Screening Auditivo. - Líderes en Audiología Clínica
Mar. Ene 14th, 2025

Autorización y Cuestionario para Screening Auditivo.

Autorización y cuestionario para Screening Auditivo

Solo rellenar en el caso de menores.
Importante indicar un correo válido
Importante indicar un teléfono válido por si nos tenemos que poner en contacto con usted.
Este documento sirve para que usted, o quien lo represente, dé su consentimiento para las pruebas auditivas y visuales que se le van a realizar en su colegio. Pulsar el "Si" significa que nos autoriza a realizarlas. De su rechazo no se derivará ninguna consecuencia adversa, sólo que no se le realizarán dichas pruebas.
En el caso que sea necesario puede seleccionar varias opciones
En el caso que sea necesario puede seleccionar varias opciones.
¿Tienes acúfenos? ¿Pérdida auditiva?
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