Referral - Audiological Services

A referral for audiological services is required as described in the SHARS Handbook.

This form in SameGoal is designed to document a referral for audiological services. It captures:

• Date of referral
• Name of referring licensed physician
• National provider identifier (NPI)
• Additional information/comments
• Whether documentation is attached

As a best practice, districts may attach a copy of the referral to the document in SameGoal.