Skip to Local Navigation
Skip to Content
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. Information & Audio-Visual Release Form (English)
    Information & Audio-Visual Release form (Spanish)
2. Emergency Card
3. Fee Statement (Fall/Spring; Summer Block I; Summer Block II)
4. Exchange of Information (Child-English)
    Exchange of Information (Child-Spanish)
5. Exchange of Information (Adult-English)
    Exchange of Information (Adult-Spanish)
6. Attendance Policies (English)
    Attendance Policies (Spanish)
7. Medicare Policy
8. Clinical Reports Notes 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. Clinic Application
10. Goal Writing Format
11. Standard IV-C Clarification: Direct vs. Indirect Contact Hours