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Hearing monitoring

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • Referral for baseline hearing assessment prior to treatment for patients undergoing ototoxic treatment
  • Re-assessment / monitoring of hearing for those who are currently being treated with ototoxic agents
  • Suspected ototoxicity related to long term and/or GP prescribed medication

Category 2

Appointment within 90 days is desirable

  • Long term monitoring of for ototoxic treatment (CF, haematology) over a long period of time

Category 3

Appointment within 365 days is desirable

  • No Category 3 criteria

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • No other information

Referral requirements

A referral may be rejected without the following information.

Essential referral information

Referral will be returned without this

  • Reason why hearing needs to be monitored

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 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
  • Any previous audiology assessment results
  • The person’s hearing and communication needs at home, at work or in education, and in social situations
  • Psychosocial difficulties related to hearing

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • 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

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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