LSU Speech, Language, Hearing Clinic by HC121104002213

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									                                             Clinician:
                                             Supervisor:
                                             Client:              DOB:


               LSU Speech, Language, Hearing Clinic
                        Speech Therapy
                      Weekly Status Report

Date:                     Session #:                  Dx:
________________________________________________________________________

Subjective
 Caregiver Report:

   Clinician Observations:



Objective
 Ct. was seen for ___ minutes of ______________________________________.



Assessment
 Ct. demonstrates improvement with ___________________________________.
 Ct. requires further improvement with _________________________________.


Plan
____Continue goals/objectives as stated
____Modify plan as follows:________________________________________________
_______________________________________________________________________
_______________________________________________________________________
____Conduct caregiver education ____________________________________________
____Home program _______________________________________________________
_______________________________________________________________________
____Contact other professional ______________________________________________
____Complete otoscopy/typmanometry _______________________________________
____Other ______________________________________________________________



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            Clinician                                    Date
                          Last Updated: 11/3/2012

								
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