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Ototoxic Medications
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C662 HEARING LOSS SERVICES EDMONTON, AB T5J 2S5 …
www.wcb.ab.caOtotoxic Medications (Surname) (First Name) Claim Number: Background Information Right (R) Left (L) Hearing Difficulty Tinnitus Intermittent Tinnitus Constant Pressure / Fullness Ear Infections Surgery Head Trauma Ear Pain Style Serial Number Right Left Comments Results Degree of Hearing Loss Mild (26-40 dBHL) Moderate (41-55 dBHL) Moderate ...