UCLA Audiology and Speech Pathology

Speech Pathology Services

Preparing for your Appointment

Please check-in 15 minutes prior to your appointment time.
Please bring in your insurance card and photo identification.

Please complete the appropriate questionnaire and bring it to your appointment.
- Child Communication Questionnaire
  Ages 17 months to 15 years
  - In English- Pediatric_Questionnaire.pdf
  - In Spanish- Pediatric_Questionnaire_Spanish.pdf
  - In Farsi- Pediactric_Questionnaire_Farsi.pdf
  - In Korean-Pediatric_Questionnaire_Korean.pdf
- Voice Evaluation
  - Voice Evaluation_Questionnaire.pdf
- Gender Congruent Voice Evaluation
  - Gender Congruent Voice_Questionnaire.pdf
- Supragastric Belching Evaluation
  - Supragastric Belching_Questionnaire.pdf
- Swallow and Speech Preservation
  - Swallow and Speech Preservation_Questionnaire.pdf
- Adult Neurological
  - Adult Neurological_Questionnaire.pdf

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