Client History Forms

Intake Forms

Below are the forms necessary for new patients to be seen at WWU's Speech-Language Clinic. If you have questions about which forms to complete, or how best to complete them please reach out to our front desk at (360) 650-3881.

Speech-Language Intake Forms - English

Adult Client Intake Form
 - Fillable PDF
 - Print Word

Pediatric Client Intake Form (17 years of age and younger)
 - Fillable PDF
 - Print Word

Gender-Affirming Voice Client Intake Form
 - Fillable PDF
 - Print Word

Clinic Consents and Policies Form
 - Fillable PDF
 - Print Word

Habla y el lenguaje: formulario de admisión en español

Clínica del habla y el lenguaje: formulario de admisión para pacientes adultos
 - Imprimir Word

Clínica del habla y el lenguaje: formulario de admisión para pacientes pediátricos
 - Imprimir Word

Formulario de consentimientos y políticas de la clínica
 - Imprimir Word