Cerumen Removal Consent Form
Your audiologist may decide it would be best to remove ear wax from your ear canal. Removing ear
wax is something that should be done by a professional. Every precaution possible will be taken to
avoid discomfort or adverse results. Complications and side effects of cerumen removal are rare and
may include:
Cerumen remains: If your audiologist is unable to remove the cerumen, you will be directed to see
your primary care provider or otolaryngologist (ENT) for further treatment.
Discomfort: Some people may feel mild to moderate discomfort during the procedure.
Injury to the ear canal: Abrasions to the ear canal may occur during cerumen removal. Some
bleeding may occur during the procedure. Bleeding is usually slight and resolves on its own.
If you decide you do not want to have your wax removed at any time, you may stop the procedure.