Audiogram
Use a Audiogram 2011 template to make your document workflow more streamlined.
What an Audiogram records
An Audiogram is a hearing-test record that documents a patient’s hearing thresholds and related clinical information. In practice, it may identify the patient, record test dates and frequencies, show right- and left-ear results, identify the audiologist or provider, and include interpretation or acknowledgment fields. With signNow, a clinic can upload the Audiogram, review detected fields, assign patient and provider roles, send it for electronic signatures, and preserve the completed document with an audit trail. Healthcare organizations should apply HIPAA safeguards and their own clinical-record retention policy to every completed Audiogram.
Who uses Audiograms and why
Healthcare providers
Audiologists and hearing clinics use Audiograms to document hearing thresholds, patient identifiers, testing conditions, and clinical interpretation before routing records for acknowledgment or signature.
Patients and representatives
Patients and authorized representatives review Audiograms containing hearing-test results, confirm information, and sign consent or acknowledgment sections when the clinic requires documented approval.
Features that support Audiogram workflows
signNow connects Audiogram preparation, field assignment, patient review, signature collection, and auditable record storage in one controlled workflow.
Field detection
Upload an Audiogram PDF and identify its patient, provider, date, threshold, and acknowledgment fields before sending.
Signer routing
Assign each Audiogram field to the patient, audiologist, physician, or authorized representative who must complete it.
Remote signing
Collect signatures remotely without requiring every Audiogram participant to attend the clinic simultaneously.
Audit trail
Preserve timestamps, signer actions, and delivery events alongside the completed hearing record for review.
Data protection
Keep Audiograms protected with TLS 1.2/1.3 in transit and AES-256 encryption at rest.
Reusable templates
Reuse an approved Audiogram template while limiting changes to authorized administrators and designated senders.
How to complete an Audiogram online
Complete the Audiogram by preparing its clinical fields, assigning authorized signers, collecting signatures, and preserving the finished record.
Upload the form: Upload the Audiogram PDF and let signNow detect fillable fields. Review fields: Review patient and provider fields before assigning signer roles. Send securely: Send the Audiogram to authorized signers by email or signing link. Archive records: Collect signatures and store the completed record with its audit trail.
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Steps to complete an Audiogram
Use this workflow to turn an Audiogram PDF into a completed, signed, and traceable healthcare record.
Upload Audiogram:
Upload the Audiogram PDF to signNow. Check fields:
Review detected patient and provider fields. Assign signers:
Assign each field to the correct signer. Send for signature:
Send the completed workflow and monitor signing. Store record:
Download the signed Audiogram with audit trail.
What the Audiogram audit trail records
The audit trail documents identity, timing, document integrity, and retrieval history for each completed Audiogram workflow.
Authenticate signer:
Capture timestamp:
Record document hash:
Seal document:
Log document events:
Export audit trail:
Find and fill out the correct audiogram
airSlate SignNow helps you fill in and sign documents in minutes, error-free. Choose the correct version of the editable PDF form from the list and get started filling it out.
| Versions | Form popularity | Fillable & printable |
|---|---|---|
| *2011 ICSD Audiogram Form [2011-06] 2011 | 4.8 Satisfied (2558 Votes) |
Recommended Audiogram workflow settings
Configure the Audiogram workflow around signer identity, protected health information, auditability, retention, and controlled access.
| Audiogram setting | Recommended configuration |
|---|---|
| Authentication method | Two-factor authentication for protected health information |
| Signature type | Typed or drawn electronic signature |
| Audit trail | Enable complete signing history and timestamps |
| Document retention | Six years for HIPAA records under 45 CFR 164.530(j) |
| Encryption | TLS 1.2/1.3 in transit and AES-256 at rest |
Audiogram record retention schedule
Retention depends on whether the Audiogram is a HIPAA-covered record and whether state healthcare rules require a longer period.
Six years for HIPAA records
No tax period applies
No employment period applies
State period may be longer
Policy-controlled final retention
Best practices for retaining Audiograms
Use a documented retention, access, and review process so completed Audiograms remain accurate, private, and auditable.
Set retention for completed Audiograms
Export the signed record and history
Restrict access to patient records
Review clinical fields before sending
Security for Audiogram records
HIPAA safeguards:
TLS 1.2/1.3 encryption:
AES-256 at rest:
SOC 2 Type II certification:
ISO 27001 certification:
Signed document history:
Platform requirements for Audiograms
Complete Audiograms through signNow using Chrome, Firefox, Safari, or Edge on Windows or macOS. signNow also provides iOS and Android apps for reviewing, sending, and signing documents. Use an internet connection protected by TLS 1.2 or TLS 1.3 when transmitting patient records.
Supported browsers Chrome, Firefox, Safari, Edge Desktop systems Windows and macOS Mobile apps iOS and Android apps
Healthcare deployments should use managed devices, role-based access, and approved storage policies for Audiograms. Organizations requiring system-to-system routing can evaluate signNow API access and integrations with platforms such as Microsoft 365, Google Drive, Box, or Salesforce. Confirm HIPAA requirements, including a business associate agreement where applicable, before processing protected health information.
Key performance indicators that demonstrate SignNow's proven track record.
Audiogram troubleshooting questions
Resolve field, signer, privacy, plan, and access issues before the Audiogram becomes part of the patient record.
Upload the Audiogram as a PDF, then review signNow’s detected fields manually. Hearing thresholds, ear labels, test dates, and provider identifiers may require repositioning or correction before sending.
Use signNow’s signer roles and field assignments to distinguish the patient, audiologist, physician, and authorized representative. Confirm every required field has one responsible signer before selecting Send.
signNow supports HIPAA-compliant workflows when a business associate agreement is required. Confirm the organization’s account configuration and healthcare privacy procedures before uploading protected health information.
Business includes legally binding eSignatures, audit trails, templates, mobile apps, ISO 27001, SOC 2, and GDPR support at $8 per user monthly when billed annually.
Business Premium adds bulk send at $15 per user monthly when billed annually. Use it only when the clinic needs repeated Audiogram delivery across many recipients or records.
If a signer cannot open the Audiogram, verify the email address, resend the invitation, or provide a signing link. For sensitive records, use two-factor authentication and confirm the recipient’s identity first.
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