Pediatric Hearing Loss Webinar for Professionals

Thank you for your interest in the webinar! We appreciate your enthusiasm and will reach out to you in the coming weeks with further details. If you have any questions or comments about the webinar or FHSR, please feel free to contact us at educationintern@fhsr.org. We look forward to connecting with you!

As a reminder, we’ll be covering critical topics related to the impacts of hearing loss on children, the importance of timely screenings, and effective intervention strategies. We believe the insights shared during the webinar will be beneficial for professionals in the field and can help drive positive outcomes for children with hearing loss.

To register the webinar, please complete the below sign-up form.
Email *
Name:  *
Email:  *
Zip Code of Service:  *
Zip Code of Residence: *
Race:  *
Gender:  *
What is your profession?  *
How Many Years of Experience in Your Field?  *
Have you worked with patients with hearing loss?
*
If you answered "Yes" to "Have you worked with patients with hearing loss?", please describe your experience.
Have you received any specific training related to pediatric hearing loss?
*
If you answered "Yes" to "Have you received any specific training related to pediatric hearing loss?" , please describe your experience.
What are your main goals for attending this webinar?
*
What specific topics are you most interested in learning about during our webinar? (select all that apply)
*
Required
What resources or training do you think would enhance your confidence in managing pediatric hearing loss? (Check all that apply)
*
Required
Do you have any specific questions or concerns about early intervention for hearing loss that you would like addressed during the webinar?
*
Do you have any specific accommodations?  *

Please choose the date and time that work best for you (select all that apply)

*
Required
Do you want to sign up for the FSHR newsletter to find out more about our free programs & to receive handouts about hearing loss?
*
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of FHSR.

Does this form look suspicious? Report