The forms below may be filled out on your computer using Adobe Acrobat Reader (available for free from Adobe). The form can then be emailed to the clinic at arehm@uca.edu We cannot guarantee that your email communication with us will be secure. If you do not want to use Adobe Reader and submit the application online, you can print the form and fax or mail it to the clinic.
Evaluation Forms:
Audiology Adult Evaluation Form
Audiology Child Evaluation Form
Fluency (Stuttering) Adult Evaluation Form
Fluency (Stuttering) Child Evaluation Form
Literacy Child Evaluation Form
Acknowledgment of receipt of NPP
Registration Forms:
Registration Form Therapy-Fall 2022