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Audiology Assessment Center

Eugene Brucker Education Center
Annex 17
4100 Normal St
San Diego, Ca 92103
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Forms for Staff

The following applications need to be filled out completely and faxed to (619-497-3521) or mailed to the Audiology Assesment Center at the Ed Center, Annex 17.

APPLICATION FOR AUDIOLOGIC SCREENING/EVALUATION (for Staff Only)

REQUEST FOR TRIAL WITH AN ASSISTIVE LISTENING DEVICE (for Staff Only)

REQUEST FOR AUDITORY PROCESSING EVALUATION (for Staff Only)
PRE-TRIAL INVENTORY (for Staff Only)
L.I.F.E. (Listening Inventory for Education) (for Staff Only)