Referral documents

Current SSNHL Program documents. Fax completed referrals with a recent audiogram to 403-592-4289.

SSNHL Referral Form

Sudden Sensorineural Hearing Loss Referral. All referrals must include a recent audiogram performed after the reported hearing loss occurred. Incomplete referrals will be faxed back to the referral source without being triaged.

PDF, 1 page, 101 KB. Form 22286 (Rev2026-04)

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Patient handout

Sudden Hearing Loss – Patient Information. What SSNHL is, how it is diagnosed and treated, living with tinnitus and a blocked feeling in the ear, and when to call 911. You can also read it online.

PDF, 2 pages, 120 KB

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