Many of our forms are in PDF format and require you to use Adobe Reader so you can complete them electronically. If you do not have Adobe Reader please follow this link to the free download: http://get.adobe.com/reader/

Clinic:

Clinic Applications:

• Child (0-17 years) Speech & Language Assessment Application [pdf]
• Adult (18+ years) Speech & Language Assessment Application [pdf]

 Student Clinician Forms:

• Chronology Form [pdf]
• Confidentiality Agreement [pdf]
• Consent and Release Form [pdf]
• Hepatitis B Consent/Refusal Form [pdf]
• LiveScan Fingerprinting Form [pdf]

Evaluation and Observation Forms:

• Extern Supervisor Rating Form [pdf]
• Observation Hours Form [pdf]
• Record of Supervised Clinical Experience [pdf]

Audiology Forms:

• Communication Tips [pdf]
• Hearing Screening [pdf]
• Hearing Screening Results [pdf]
• Hearing Evaluation Report [pdf]
• Audiological Case History [pdf]

Departmental Forms:

• Candidacy Form [pdf]
• Major Form [pdf]
• Change of Major or Minor Form (for students with fewer than 90 units)
• Change of Major or Minor Form (for students with more than 90 units)
• Special O Permit Request Form [xls]
• Special Sessions Registration and Drop Form [pdf]
• University Forms
• Additional GAPE Forms
• NSSLHA Membership Application [pdf]
• Instructions for Preparing a Requisition Form [pdf]