Department of Communication Sciences and Disorders

School of Health and Human Sciences

The forms below should be completed and returned to the UNCG Speech and Hearing Center prior to attending an appointment.  For questions, call (336) 334-5939.

UNCG Speech and Hearing Center
300 Ferguson Building
524 Highland Ave.
Greensboro, NC 27402
or
Fax: (336) 334-4475

New Client Forms

All clients should complete the following:

Please note:  Forms that are fillable must be downloaded to your computer, closed, and opened in order to save the information.  These forms also can be printed and filled out by hand.

Audiology Client Forms

(Complete as appropriate)

Patients to be seen for evaluation of hearing or auditory processing should complete the following:
Patients to be seen for tinnitus should complete the following:
Patients to be seen for sound sensitivity (hyperacusis) should complete the following:
Patients to be seen for misophonia should complete the following:

Speech and Language Client Forms

(Complete as appropriate)