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Audiologists use the following criteria to determine if a medical referral is necessary: Hearing loss in an individual under the age of 18 (FDA, 1977) Pain or fullness in the ear(s) (FDA, 1977) Physical malformation of the ear(s) (FDA, 1977) Foreign body or excessive cerumen in the ear(s) (FDA, 1977) Active drainage from the ear(s) within the past 6 months (AAO-HNS, 1993, 1994) Sudden or rapidly progressing hearing loss within the past 6 months (AAO-HNS, 1993, 1994) Dizziness or recurrent episodes of dizziness (AAO-HNS, 1993,1994) Sudden or recent onset of unilateral hearing loss (AAO-HNS, 2015) Conductive hearing loss (FDA, 1977) Bilateral hearing loss of greater than 90 dB (AAO-HNS, 1993, 1994) Hearing loss with history of a variety of comorbidities including, but not limited to HIV, Menieres disease, autoimmune disorders, neurofibromatosis, history of ear infections, noise exposure, family history of hearing loss, ototoxic medication use, otosclerosis, or head trauma (AAO-HNS 1993, 1994, 2015) Should any of the above be noted, audiologists may refer the patient to an ENT or ear, nose, and throat doctor