Neuromonics Stage 2 Transition Follow-Up Call Post-Fit ~ 10 Weeks (Record on Transition Follow-Up Form) Form Needed for To assess how the patient is adjusting after transition. It is important to remind the Courtesy Call patient that the purpose of Stage Two of treatment is to gradually expose them to more of the tinnitus by reducing the level of treatment interaction. Patients may need an Patient Record: additional follow-up appointment to receive extra support while they are adjusting to Transition using the treatment and not receiving a high level of tinnitus relief as they did in Stage Form One. Review Patient’s initial response to Stage Two: (~10 wks Post Fit) Is the treatment Comfortable Yes No (Why?) Level of interaction with treatment and tinnitus? Low Moderate High At this prescribed interaction level do you feel Satisfactory Unsatisfactory that you are achieving relief from the tinnitus? Forms & Items Questions or comments? Needed at this Extra follow-up appointment or phone call? Yes Date:__________ Appointment Stage Two follow-up appointment (~ 16 weeks) Date: ____ Patient Record: Stage Two Stage 2 Appointment ~ 16 Weeks Post-Fit Tab Forms (Record on Two Form ) Computer Tinnitus Reaction Questionnaire (TRQ) - Complete and review with Determine % Awareness: Over the past week, what percentage of the time were you aware Neuromonics of your tinnitus? NeuroFit Determine % Disturbance: During the time that you were aware of your tinnitus, what Software and percentage of that time was it bothersome? NOAH 4 Broadband Minimum Masking Level Only to be conducted if in discussion with the patient and in reviewing the TRQ in- sufficient progress is being made. (See Assessment or Transition Guide for Instructions) USB cable Loudness Discomfort & Residual Inhibition Only to be conducted if the patient presented with reduced LDLs at the assessment Patient Oasis Device appointment. (See Assessment or Transition Guide for Instructions) View Data Log from patient’s Oasis Device Adjustment of any device features as indicated Monitor and review Treatment Progression Address any questions or concerns
Neuromonics Stage 2 Form Needed for Courtesy Call Patient Record: Transition Form (~10 wks Post Fit) Forms & Items Needed at this Appointment Patient Record: Stage Two Tab Forms Computer with Neuromonics NeuroFit Software and NOAH 4 USB cable Patient Oasis Device Transition Follow-Up Call Post-Fit ~ 10 Weeks (Record on Transition Follow-Up Form) To assess how the patient is adjusting after transition. It is important to remind the patient that the purpose of Stage Two of treatment is to gradually expose them to more of the tinnitus by reducing the level of treatment interaction. Patients may need an additional follow-up appointment to receive extra support while they are adjusting to using the treatment and not receiving a high level of tinnitus relief as they did in Stage One. Review Patient’s initial response to Stage Two: Is the treatment Comfortable Yes No (Why?) Level of interaction with treatment and tinnitus? Low Moderate High At this prescribed interaction level do you feel Satisfactory Unsatisfactory that you are achieving relief from the tinnitus? Questions or comments? Extra follow-up appointment or phone call? Yes Date:__________ Stage Two follow-up appointment (~ 16 weeks) Date: ____ Stage 2 Appointment ~ 16 Weeks Post-Fit (Record on Two Form ) Tinnitus Reaction Questionnaire (TRQ) - Complete and review Determine % Awareness: Over the past week, what percentage of the time were you aware of your tinnitus? Determine % Disturbance: During the time that you were aware of your tinnitus, what percentage of that time was it bothersome? Broadband Minimum Masking Level Only to be conducted if in discussion with the patient and in reviewing the TRQ in- sufficient progress is being made. (See Assessment or Transition Guide for Instructions) Loudness Discomfort & Residual Inhibition Only to be conducted if the patient presented with reduced LDLs at the assessment appointment. (See Assessment or Transition Guide for Instructions) View Data Log from patient’s Oasis Device Adjustment of any device features as indicated Monitor and review Treatment Progression Address any questions or concerns