Speech-Language Pathology Program

Case History Forms

An age appropriate Case History Form must be completed and submitted prior to your first appointment.  Please call the Speech-Language-Hearing Clinic @ (419) 530-4339 to obtain this form.

The form may be submitted via e-mail to speechclinic@utoledo.edu, faxed to (419) 530-4346, or mailed to the address below.

The University of Toledo
College of Health and Human Services
Speech Language Pathology
Main Campus -2801 W. Bancroft
1240 C HHS/ MS 119
Toledo, OH 43606

Last Updated: 6/9/16