Forms

Application Instructions

• Detailed Application Instructions – Child (pdf)
• Detailed Application Instructions – Adult (pdf)

Application Forms

The following forms may be printed and returned by mail, or printed/scanned and then returned by email to [email protected].

• Initial Application Form – Child (pdf)
• Initial Application Form – Adult (pdf)
• Aplicación inicial para niños (pdf)

• Information Release Authorization Form (pdf)
• Medical History Form (pdf)
• School History Form (pdf – for child applicants)

Mailing Address

If submitting materials by mail, use the mailing address below (which differs from our building’s physical address):

SDSU Speech-Language Clinic
5500 Campanile Drive
San Diego, CA 92182-1518

Non-Discrimination Policy

The SDSU Speech-Language Clinic prohibits discrimination based on age, citizenship, disability, ethnicity, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, and veteran status. Scheduling of clients/or appointments for service at our clinic is based on student training needs, space availability and supervisor recommendations.

Privacy Practices

All contacts with our programs are held in strict confidence, except where disclosure is required by law. Reports and other information regarding clients will not be released to any individuals or outside agencies without written consent to do so.