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California State University, Long Beach
Department of Speech-Language Pathology



For Clients

Persons served in the CSULB clinic are treated in a nondiscriminatory manner, without regard to race, color,religion, sex, national or ethnic origin, disability, age, sexual orientation, genetic information, citizenship, or veteran status.

1. Audio-Visual Release Form (English)
    Audio-Visual Release Form (Spanish)
2. Emergency Card
3. Fee Statement (Fall/Spring)
4. Exchange of Information (English)
    Exchange of Information (Spanish)
5. Attendance Policies (English)
    Attendance Policies (Spanish)
6. Medicare Policy
7. Clinical Reports Receipt Form
8. Clinical Report Request Form

For Student Clinicians

1. HIPAA Policies
2. Client Status Form
3. Client Attendance Form
4. Individual Clinic Clock Hour Form
5. CSULB Clock Hour Summary Form
6. Writing Rubric
7. Clinic Grading Guidelines
8. Clinic Handbook
9. Clinical and Internship Application
10. Goal Writing Format
11. Standard IV-C Clarification: Direct vs. Indirect Contact Hours