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.
Once the forms are completed, please attach forms and send back in an email to SLHclinic@wwu.edu
If you print the forms, please mail to
Speech-Language and Hearing Clinics
516 High Street
AIC 256, MS 9171
Bellingham, WA 98225
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