Referral Steps

Requesting Equipment for Your Student

To assist Auditory Outreach in processing requests as efficiently as possible, please ensure a completed request for equipment is submitted to Auditory Outreach once all signatures have been obtained (audiologist and school/district authorizations), and all sections are complete with accompanying documents including the permission form and audiological report. 

 A completed request includes:

1. Audiologist authorization

2. School district authorization

3. Student's 9-digit PEN (personal education number)

4. Equipment being requested including number of receivers

5. Audiology report or audiogram (within approx. one year of date of request)

6. Permission to share form including school/district and clinic

7. Dates - Please ensure forms include dates. eg. audiologist and SD authorization sections

Referral Forms can be found here: Forms

Please send your completed request:

By fax: 1-604-485-2759

Email: info@auditoryoutreach.ca

Mail to: Auditory Outreach, PRP, 7105 Nootka Street, Powell River, BC, V8A 5E3 

You will be notified when equipment is being shipped or if the submission is incomplete and requires additional information to process.