Fillable CDDS 267 Off Campus Hours Log Medical Placement

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CDDS 267 Off Campus Hours Log Medical Placement

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____________________________ ___________________ _____________________
Supervisor’s Signature License # ASHA CCC Account #
California State University, Fresno
Speech, Language & Hearing Clinic
559-278-2422
CDDS 267 - MEDICAL OFF-CAMPUS SPEECH THERAPY HOUR LOG
____________________________ __________________________________
Clinician Supervisor
_____________________________ ____________
Client Circle One: Adult Child Semester
Date
Lang.
Artic.
Voice
Fluency
Dysphagia
Staffing
Absent
Total
Date
Lang.
Artic.
Voice
Fluency
Dysphagia
Staffing
Absent
TREATMENT HOURS
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CDDS 267 Off Campus Hours Log Medical Placement

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Completed 22 May 2020

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