Sample of a Speech Pathologist's Report
Format For A&EP Electronic Communication Devices Scheme Application
This is a simple format, which may assist you in completing an application for a device from the Scheme. It is not a prescribed format.
We do not require a long, extensive report (1-2 pages max) so these guidelines may help in capturing the necessary information.
PART A - Basic Information
- Client's Name
- Date of Birth
- Address
- Contact Person
- Telephone
- Date of Report
- Diagnosis
PART B -Topics to cover
- Background of client
- Current communication
- Communication needs
- Features required in equipment
- Equipment tried/ trialed
- Positioning/ access eg switch and scanning
- Equipment recommended including any accessories eg switches, carry bags etc
Part C - Signing off report
The report is then completed and signed by the Speech Pathologist and dated and returned with the completed Application Form to the A&EP Office.