HEARING AID APPRENTICE VERIFICATION OF TRAINING AS AN APPRENTICE
Name of Colorado Hearing Aid Apprentice:
Name of Supervisor:
Hearing Aid Apprentice License Number:
Telephone Number: (
)
The above-named person, to be licensed as a hearing aid provider apprentice, will complete at least the first 6 months of training under direct supervision, including a minimum of 300 documented hours of onsite supervised training as a hearing aid apprentice in the following areas: •
Taking and reviewing case histories.
•
Otoscopy.
•
Hearing tests including air conduction and bone conduction with proper masking.
•
Speech testing including SRT, MCL, UCL, and discrimination with proper masking.
•
Interpretation of hearing tests and making medical referrals as necessary.
•
Taking of ear impressions including standard and completely in canal.
•
Fitting and post-fitting counseling including the delivery of the hearing aids, how to insert and remove the hearing aids, change batteries, and instructing the user and family as to expectations and performance.
•
Checking for proper fit and progress, and making needed adjustments.
•
Verification of hearing aid performance to determine if the hearing aid is correcting and conforming to the hearing loss as expected.
I understand that I must continue to monitor and sign all audiograms performed by the apprentice named herein, and approve all orders for hearing aids. I agree to notify the Office of Hearing Aid Provider Licensure within ten (10) business days if the apprentice leaves my supervision other than through obtaining full licensure as a hearing aid provider.
Supervisor Signature
1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800
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HEARING AID PROVIDER ... Name of Supervisor: Telephone Number: ( ) ... business days if the apprentice leaves my supervision other than through obtaining full ... Hearing Aid Provider - Verification of Completion of Training as an.pdf.
a privilege, not a right. One thing you must do to obtain the privilege is to be complete and accurate in. disclosing information on your application. Be sure to list ...
state or territory of the United States or in a foreign country; and ... An unlicensed person in this state training to be a licensed hearing aid provider after June 30,.
... the website of the appropriate board or. program. Page 3 of 3. Hearing Aid Provider Application Checklist.pdf. Hearing Aid Provider Application Checklist.pdf.
Page 1 of 11. Colorado Revised Statutes 2017. TITLE 12. Professions and Occupations. ARTICLE 5.5. Hearing Aid Providers. DISCLAIMER: This is not an official copy of the Colorado Revised Statutes. The Colorado. Revised Statutes are available for publi
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