Patient Name: _______________________________________________________

Appointment Date: ________________________________

Time: _____________1) ABR testing evaluates hearing levels without the active participation of your child. It is necessary for your child to be asleep during this test. For that reason, an oral sedation medication is given to your child in the office. Please allow approximately 2-3 hours for your child to be sedated and for the test to be performed.

2) The amount of time required for testing is often determined by how fast your child is able to fall asleep. Your child needs to be sleepy when they arrive for their appointment, as the sedation medication will not be effective if they are too awake. (Hint: Have your child stay up late the night before the appointment and wake up early the morning of the appointment. Do not let him/her sleep in the car on the way to the appointment.)

3) Please weigh your child prior to the appointment (within approximately 48 hours).

4) Do not let your child have anything (heavy) to ear or to drink approximately 4 hours prior to the appointment time, as the combination of the medication and food may cause stomach irritation in some children.

5) If your child has any medication allergies or a seizure disorder, please notify us immediately.

Thank you for your cooperation. If you have any questions, please call our office.