The following forms may be printed and returned by mail, or printed/scanned and then returned by email to firstname.lastname@example.org.
- Information Release Authorization Form (pdf)
- Medical History Form (pdf)
- School History Form (pdf – for child applicants)
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
The SDSU Speech-Language Clinic does not discriminate in the delivery of professional services on the basis of race or ethnicity, age, religion, national origin, sexual orientation, disability or ability to pay. Scheduling of clients/or appointments for service at our clinic is based on student training needs, space availability and supervisor recommendations.
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.