St Mary’s Primary School - Batlow eNewsletter

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HEARING CHECK PARENT CONSENT FORM

The school is conducting hearing tests utilising the hearing screening App Sound Scouts. The App has been developed by Sount Scouts HQ in collaboration with Australia's National Acoustic Laborities, the research arm of Hearing Australia and is supported by the Department of Health.

Your child will play a game on an iPad/tablet or smart phone using a set of headphones under the supervision of a responsible adult. A report will be automatically generated following the test. Hearing assessment is encouraged due to the importance of early intervention of hearing issues. Optimal educational outcomes are dependent on good hearing.

If you would like your child to participate in the test please complete and sign this form:

First Name *

Last Name

Email *

Child's Name *

Year *

What is your child's month and year of birth? (MM/YY) *

Does your child speak more than one language? *

Has your child had any history of hearing problems? For example, has he/she ever been fitted with grommets? *

If yes, please provide details. *

Has your child had any history of learning or attention disorders? *

If yes, please provide details. *

I have read the above information and agree to my child having their hearing checked using Sound Scouts. Signature *

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Write your signature above the line

Date *