New EHDI IS User Intake Form

Thank you for starting the process that will enable you to report results into the Early Hearing Detection and Intervention (EHDI) Information System (EHDI IS). Please review the following documents and complete this form to request your access credentials. Access is typically granted within 2-3 business days. Please review the following PDFs:


EHDI Confidentiality Statement: https://tinyurl.com/OREHDIConfidentiality

Intro to EHDI IS: https://tinyurl.com/OREHDIISIntro

My electronic signature certifies that I have read and fully understand the EHDI Confidentiality Statement. I understand that I have a duty to protect confidential client information. I will abide by these requirements. I further understand that a breach of confidentiality would result in denial of all future access to the EHDI IS, as well as possible civil and/or criminal liability. Please enter full name.

Is your clinic listed and up-to-date on EHDI-PALS.org?
Indicate the age of children you can serve:

Which procedures do you perform? Check all that apply.

Accept OHP?

Knowledge review

Please answer the following questions, referring to the PDFs provided above. You will be directed to the correct answers after you submit your responses.

By law, who must report hearing status of newborns to the Oregon EHDI program?
The "10 days rule" refers to:
Which of the following must be reported to EHDI within 10 days?
How do I notify EHDI if information is inaccurate in the database?
If hearing loss is identified in a child under age 3, who is required to make a referral to early intervention?
The national and state EHDI goals are:
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