Clinic Applications

Please use the following forms to apply to the KACCD. The information page and the letter to prospective clients describe our services and fees. Print them out as needed. You will need an Adobe Reader to download the forms.
ENGLISH
Child (0-17 years) Speech
& Language Assessment Application [pdf]PDF WRITABLE
Adult (18+ years) Speech &
Language Assessment Application [pdf]
SPANISH (espanol)
Child (0-17 years) Speech & Language Assessment
Application [pdf]
Adult (18+ years) Speech & Language Assessment
Application [pdf]