clinic manual of operation

manual of operation image The Manual of Operation lists information and forms used at the Center for Communication Disorders (CCD).  Click on the links below to access PDF copies of the Manual and its appendices.

Manual of Operation

Appendix A - Center Brochure

Appendix B - ASHA Code of Ethics

Appendix C - Confidentiality

Appendix D - FAQ Video/Audio Recording

Appendix E - Observation Guidelines

Appendix F - FAQ Observation

Appendix G - Observation Form

Appendix H - Fire and Medical Emergencies Policies

Appendix I - Diagnostic Billing

Appendix J - Audiology Billing

Appendix K - Clinical Encounter Form

Appendix L - Fee Reduction Request Form

Appendix M - Speech-Language Pathology Practica Competency Review

Appendix N - Audiology Practicum Competency Review

Appendix O - Clinical Clock Hour Summary

Appendix P - Non-Contact/Modification Clinical Experience Form

Appendix Q - FAQ Regarding Borrowing Clinic Materials

Appendix R - Student Evaluation of Clinical Instruction

Appendix S - Intake Screening

Appendix T - Audiology Follow-Up Appointments

Appendix U - Application Packet Materials

Appendix V - Appointment Card

Appendix W - Exchange of Information Form

Appendix X - Letter Requesting Information from Other Providers

Appendix Y - Face Sheet

Appendix Z - Application for Clinical Services/Authorization to Use Clinic Materials

Appendix AA - Diagnostic Intake Form

Appendix BB - Child Case History - Audiology

Appendix CC - Adult Case History - Audiology

Appendix DD - Adult Case History - Speech-Language Pathology

Appendix EE - Child Case History - Speech-Language Pathology

Appendix FF - Hearing Screening

Appendix GG - Pure Tone Audiogram

Appendix HH - Serial Audiogram

Appendix II - Diagnostic Planning Worksheet

Appendix JJ - Report Cover Letter

Appendix KK - Therapy Scheduling Form

Appendix LL - Standard Report Titles

Appendix MM - Diagnostic Report Format

Appendix NN - Checklist for Processing Diagnostic and Audiology Reports

Appendix OO - Client Files: Order of Information

Appendix PP - Student Schedule Forms

Appendix QQ - Session Plan Guideline/Example

Appendix RR - SOAP Note Guidelines/Example

Appendix SS - Chronological Summary of Activity

Appendix TT - Term Treatment Plan

Appendix UU -  Therapy Progress Report

Appendix VV - Student Quality Assurance Record Review Form

Appendix WW- Case Observation Form

Appendix XX - Intra-Center Referral Form

Appendix YY - CCD Staff Qualifications and Responsibilities

Appendix ZZ - Professionalism