Requesting Clinic Services Clinic paperwork can be downloaded from this page or are available from our clinic office. http://www.ewu.edu/chsph/programs/communication-disorders/clinic/clinical-services-forms en-us Wed, 22 Oct 2014 07:54:39 UTC Wed, 22 Oct 2014 07:54:39 UTC webmaster@ewu.edu webmaster@ewu.edu

Requesting Clinic Services

Clinic paperwork can be downloaded from this page or are available from our clinic office.case history forms, referrals, insurance providers

Referrals may be made by self, parent, physician, educator,psychologist or any other related professional or agency. We are a health care provider for many third-party insurance companies. For insurance coverage doctor's orders are frequently requested. We are not a Medicare provider. Contact the clinic to inquire about specific insurance and payment needs.

Please Note: The Hearing and Speech Clinic will accept completed paperwork via fax, mail, or hand carried to the clinic.

Hearing Services:

For hearing loss related services please use the age-appropriate case history form:

Adult Audiology

Child Audiology

Speech and Language Services: 

For Speech and language services please use the age-appropriate case history form:

Adult Speech-Language

Child Speech-Language

Privacy:

Summary of Patient Privacy (HIPAA)

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