California State University, Fresno
Speech, Language & Hearing Clinic
559-278-2422
ON CAMPUS SPEECH THERAPY HOUR LOG
____________________________ __________________________________
Clinician Supervisor
_____________________________ ____________
Client Circle One: Adult Child Semester
Date
Lang.
Artic.
Voice
Fluency
Aural Rehab.
Other
Absent
Total
Date
Lang.
Artic.
Voice
Fluency
Aural Rehab.
Other
Absent
______________________________ _________________ _____________________
Supervisor’s Signature License # ASHA CCC Account #
TREATMENT HOURS
S