Speech-Language Pathology Program

Case History Forms

Adult - Case History Form

School Age Student - Case History Form

The appropriate case history form must be completed and submitted prior to your first appointment.

The form may be submitted via e-mail to speechclinic@utoledo.edu 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: 6/26/15