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    Sample Blank Audiogram

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    Indah
    Mary L. Allen underwent an audiogram on 3/20/2011 which was administered and interpreted by audiologist SC. The audiogram shows the patient's hearing thresholds at various frequencies in both ears which indicate some mild to moderate hearing loss. Test results for speech reception, word discrimination, and tympanometry are also included in the report along with comments about air and bone conduction thresholds.

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    Sample Blank Audiogram

    Uploaded by

    Indah
    631 views1 page
    Mary L. Allen underwent an audiogram on 3/20/2011 which was administered and interpreted by audiologist SC. The audiogram shows the patient's hearing thresholds at various frequencies in both ears which indicate some mild to moderate hearing loss. Test results for speech reception, word discrimination, and tympanometry are also included in the report along with comments about air and bone conduction thresholds.

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    Mary L. Allen underwent an audiogram on 3/20/2011 which was administered and interpreted by audiologist SC. The audiogram shows the patient's hearing thresholds at various frequencies in both ears which indicate some mild to moderate hearing loss. Test results for speech reception, word discrimination, and tympanometry are also included in the report along with comments about air and bone conduction thresholds.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    631 views1 page

    Sample Blank Audiogram

    Uploaded by

    Indah
    Mary L. Allen underwent an audiogram on 3/20/2011 which was administered and interpreted by audiologist SC. The audiogram shows the patient's hearing thresholds at various frequencies in both ears which indicate some mild to moderate hearing loss. Test results for speech reception, word discrimination, and tympanometry are also included in the report along with comments about air and bone conduction thresholds.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    888-453-8806

    ABC Audiology Fax: 509-315-1469


    www.audiologyhelp.com 3339 Hwy 25, N. #44 - Northport, WA 99157
    Patient: Mary L. Allen Date of Test: 3/20/2011
    Audiologist: SC
    FREQUENCY IN HERTZ Hz
    125 250 500 750 1000 1500 2000 3000 4000 6000 8000
    -10
    NORMAL
    0
    Ability to understand speech
    10
    MILD
    20

    HEARING LEVEL IN DECIBELS (ANSI) 1989


    No significant difficulty with
    faint speech
    30 MODERATE
    40 Difficulty only with faint speech

    50 Amplification needed
    Frequent difficulty with
    60 normal speech

    70 SEVERE

    Frequent difficulty with loud speech


    80
    Understand only shouted
    90 or amplified speech

    PROFOUND
    100
    May not understand even
    110 amplified speech

    120
    8% 14% 22% 33% 23% <Value List Missing>
    IMPORTANCE OF SPEECH INTELLIGIBILITY
    SPEECH RESULTS TYMPANOGRAM pressure (mmH2O)
    Speech Most Un-
    Reception Comfortable Comfortable
    Word Discrimination .9
    Threshold Level Level Discrimination Level
    (SRT) (MCL) (UCL)
    Percentage (dB) .8
    .7

    Compliance
    Right .6
    .5
    Left
    .4
    Binaural .3
    .2
    Unaided
    Soundfield .1
    Aided 0
    Soundfield

    -300 -200 -100 0 +100 +200


    COMMENTS AUDIOGRAM KEY
    L R NR L NR R L R NR L NR R

    Bone Conduction
    Air Conduction X O X O Forehead V V V V
    Air Conduction Bone Conduction
    Masked Forehead Mask

    > < Threshold of


    Bone Conduction > < Discomfort Pure
    Bone Conduction ] [ ] [
    Masked

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