Requesting Clinic Services
     
Please begin by submitting a printed application*. Application forms can be downloaded from this page or are available from our receptionist. After your application has been received you will be contacted to schedule an appointment. Please allow 48-72 hours for this call. If you have not received a call, please contact the clinic at 206-543-5440 to confirm your application has been received.

*Please Note: At this time, the Speech and Hearing Clinic will accept completed applications via fax, mail, or hand carried into the clinic.
   

Hearing Services:

For hearing loss related services please use the age-appropriate Audiology Application:

            - Adult Audiology Application (18+ years and older)
            - Child Audiology Application (6 months to 18 years)

Adults and children applying for hearing loss related services also need to complete and return our Audiology Exchange of Information Form.
   

Speech and Language Services:

For speech and language services please use the age-appropriate Speech-Language Application:

            - Adult Speech-Language Application (15+ years and older)
            - Child Speech-Language Application (18 months to 15 yrs.)

Adults and children submitting Speech-Language applications also need to complete and return our Speech Language Exchange of Information Form.

For all services please include copies of any medical or school reports that will help us understand your history and needs.

Our FAQS page includes answers to many commonly asked questions regarding our services.
    

Privacy:

Summary of Patient Privacy (HIPAA).