Attendance and Payment Policies
|
|
- Laurel Norris
- 5 years ago
- Views:
Transcription
1 Department of Communicative Sciences and Disorders 665 Broadway, 9 th Floor New York, NY P: F: Attendance and Payment Policies Due to the increasing demand for services and our responsibility to train graduate students, the clinic must uphold the following policy: Attendance at evaluations: Consent and intake forms and payment must be received by the clinic two weeks before an appointment will be scheduled. Appointments for evaluation must be canceled one week in advance and will be rescheduled at the discretion of the clinic director. Evaluation appointments cancelled within 48 hours of the scheduled evaluation are nonrefundable. Attendance at treatment sessions: To report an absence, please call the main desk at Please make every attempt to attend each scheduled session and to arrive on time so that you or your child can make the maximum progress. If you must be absent and know ahead of time, please advise your supervising clinician as soon as possible. Make-up for sessions cancelled by the client are scheduled at the discretion of the supervisor. Every effort will be made to make up sessions canceled by our clinicians. For absences greater than two weeks in duration, your supervising clinician may ask you to consider enrolling for the following semester depending on the impact of your absence on your or your child s treatment and on the training of our student clinicians. If you have to cancel your appointment with less than 24 hours notice, the session will be counted as an unexcused absence unless there has been an emergency, illness or other extenuating circumstance. If a client fails to attend an appointment without notifying the clinician, this will also be counted as an unexcused absence. 665 Broadway, 9 th Floor New York, New York fax
2 Upon having two unexcused absences, clients will be notified of possible termination. After three unexcused absences, services will be terminated and the client will be provided with the names of other facilities for treatment. Tardiness: If the client arrives more than 15 minutes after his/her scheduled appointment, the session will be held at the discretion of the supervising clinician. If the client arrives late for more than two sessions, the supervising clinician will suggest that the client schedule the session at an alternate time or wait until the following semester for a time slot more conducive to the client s schedule. Upon three late arrivals, clients will be notified of possible termination. Safety: Children 17 years of age and under must be accompanied to their treatment session by a parent or guardian. The parent or guardian must remain in the clinic throughout the treatment session. Family, caregivers or home health aides accompanying adult clients must remain in the clinic throughout the treatment session. Failure to do so will result in discharge from treatment. Session observations: You may observe all sessions conducted with the student clinician assigned to your child/family member/person you care for. We encourage you to observe, ask questions and reinforce treatment strategies at home. I have read and agree to the terms and conditions of the attendance policy. Signature of client or parent/guardian: Date: 665 Broadway, 9 th Floor New York, New York fax
3 Payment Agreement The clinic does not accept insurance. After payment is made, we will provide copies of documentation for you to submit to your insurance carrier, at your request. Fees for all treatment services are billed at the start of each semester and are due by mid-semester. Clients who have not paid their bill in full by the end of the semester will not be scheduled for further sessions. If you require a copy of your most recent invoice, please alert the receptionist. If you are experiencing financial hardship, contact the Clinic Director, Iris Fishman, at or irf2007@nyu.edu. Invoices are payable by credit card, personal check or money order. Fees are payable to NYU. I have read and agree to pay the NYU Speech-Language-Hearing Clinic any and all charges incurred by visits and services rendered. Signature of client or parent/guardian: Date: Contact of person responsible for bill payment (if different than above): Name: Address: Phone: rev. 01/29/ Broadway, 9 th Floor New York, New York fax
4 Department of Communicative Sciences and Disorders 665 Broadway, 9 th Floor New York, NY P: F: Client Name: Date: Client Consent for Evaluation and Treatment by Student Clinicians and Audio- Visual Recording The Speech-Language-Hearing Disorders Clinic is a facility at New York University, which provides professional services to the public in speech, language, cognitive, voice, fluency and hearing evaluation and treatment. In addition to its service function, it is an integral part of the graduate teaching programs of the University. Substantially, all services at the clinic are performed by graduate student interns in the Department of Speech-Language Pathology and Audiology, under the supervision of ASHA certified and NYS licensed Speech-Language Pathologists. Client sessions are conducted and observed by graduate students and are recorded on DVD, VHS, audiotape and/or digital recorders for future discussions by graduate students and their instructors/clinical supervisors. In order for the Speech-Language-Hearing Disorders Clinic to be able to provide professional services, it is necessary that the client be willing to cooperate with the educational and research activities of the clinic and department in the ways indicated below. Clients may be assured that such activities will enhance the quality of the services provided. I have read the above statements, and I: 1. Grant permission for The New York University Speech-Language-Hearing Disorders Clinic to evaluate and/or treat the above named client. 2. Agree that services may be provided to the above-named client by graduate student interns, faculty, or clinical associates. 3. Agree that except under circumstances requiring absolute privacy, interviews and other sessions in which the above-named client participates in may be observed by graduate students and departmental faculty and may be recorded on DVD, VHS, audiotape or digital medium and that such media may be used in connection with the teaching programs of the department. If you have any questions about this statement, please ask before signing. By signing below, I agree that I have reviewed and understand the information above: Client / Parent / Guardian Signature Relationship to client Print Name Services will not be provided at the New York University Speech-Language-Hearing Disorders Clinic without this form being signed Broadway, 9 th Floor New York, New York fax
5 S P E E C H - L AN G U AG E - H E AR I N G C L I N I C: INTAKE FORM Client s Name: Date of Birth: Age: Department of Communicative Sciences and Disorders 665 Broadway, 9 th Floor New York, NY P: F: New Client / Returning Client Referred By: CONTACT INFORMATION Client/Parent or guardian name: Address: City: State: Zip: Home Phone: Cell Phone: Other Phone: Primary care physician: Phone: Fax: DIAGNOSTIC HISTORY Past diagnosis: Has the client received an evaluation/therapy before? If yes, what type? Speech / Occupational / Neurological When: Where: Date of last evaluation: Please send a copy of the evaluation. Yes / No Has the client had a hearing evaluation? Yes / No When: Where: Any history of the following: Middle ear infections Tubes in ears Asthma Allergies Seizures Other Is the client taking any medications? Yes / No If yes, please describe: LANGUAGES SPOKEN Client s primary language: Secondary language(s) spoken: Parent s primary language: 665 Broadway, 9 th Floor New York, New York fax
6 EMERGENCY CONTACT INFORMATION Name: Relationship: Address: City: State: Zip: Home Phone: Cell Phone: Other Phone: Name: Relationship: Address: City: State: Zip: Home Phone: Cell Phone: Other Phone: SERVICES SOUGHT Aphasia Fluency Voice Disorder (i.e. hoarseness) Other: Accent Modification Articulation Language SCHEDULING The clinic is open Monday- Thursday 11 am - 7pm. Please indicate availability below: Monday Tuesday Wednesday Thursday Clients are scheduled on a first come, first served basis during each academic semester. Please be sure to provide us with as many scheduling options as possible. Clients may be placed on a waiting list for services.
7 SPEECH-LANGUAGE-HEARING DISORDERS CLINIC Child Case History Form Date Child s Name M F Age Address Birth date Parent/Guardian s Name Telephone: (Home) (Work) (Cell) Address Department of Communicative Sciences and Disorders 665 Broadway, 9 th Floor New York, NY P: F: Parent/Guardian s Name Telephone: (Home) (Work) (Cell) Address Person responsible for payment Telephone: (Home) (Work) (Cell) Address (if different from above) How did you hear about us? Who is filling out this questionnaire? Relationship to child Describe your child s speech-language problem When did you first notice the problem? When did you become concerned? Who have you seen regarding this problem? (Doctor, Psychologist, etc.): 1
8 How has the problem changed since you first noticed it? What has been done about it? Has this helped? What do you think caused the problem? Family Information Parent s occupation Last grade completed in school Parent s occupation Last grade completed in school Siblings Age Age Language(s) spoken at home Are there any family members or relatives who have or had speech, language or hearing problems? Pregnancy, Birth History and Early Development This child s birth order : Is the child adopted? During pregnancy with this child, did mother have any Illness? Take medication? If so, explain: Was labor at all problematic? Explain: Was the child s birth at all problematic? Explain: 2
9 Did the child have any trouble breathing after birth? Was the child kept in an incubator? Explain: Was feeding at all a problem? If so, explain: Bottle Fed? Breast Fed? Age weaned from breast? Age weaned from bottle? At what age did child drink from an open cup, independently? At what age did child finger feed self? Able to eat with a spoon? Does the child have any problems eating now? Is she/he a picky eater? If so, explain: When did the child first get teeth? If so, explain: Has the child had dental problems? Dentist s name and telephone number? Was the child very active as a baby? When did the child learn to: sit alone? feed him/herself? dress him/herself? walk independently? How well does the child: walk? 3
10 run? throw a ball? If the child has problems with any of the above motor activities, explain: Is the child toilet trained? If so, at what age was he/she toilet trained? Does the child wet the bed now? How often? What hand does your child use to: eat? draw? write? throw a ball? How would you describe your child s current physical development? Medical History Pediatrician s name and telephone number Has the child ever been hospitalized since birth? age If so, please give reason and Has the child had any serious illnesses or accidents? If so, explain: Has the child ever fainted? Had convulsions? If so, explain: Ear infections? How long? How does the child alert you when he/she is suffering from middle ear pain? When was your child s most recent hearing test? 4
11 What was the result of the testing? (Please provide test results if available) Please describe any concerns you may have regarding your child s hearing? Does the child have any problems seeing? Wears glasses? Does the child have any trouble sleeping at night? Waking up in the morning? If so, explain: Is the child presently being seen by a pediatrician? ENT (otolaryngologist)? Psychologist? Speech therapist? Neurologist? Physical therapist? Occupational therapist? If so, explain (please provide name and telephone number of this professional): Speech History Was the child very quiet as a baby? Did she/he coo? babble? Did the child cry excessively as a baby? When did he/she speak single words (other than mama or dada )? What were the child s first few words? Approximately how many words did the child have at 18 months? When did he/she begin to combine words (two-word sentences)? Does he/she use gestures? (Give examples if possible) 5
12 If the child talks now, can you understand? Can other family members Can strangers? How do you think the child feels about his/her speech? Do you think the child stutters or stammers? Does the child use complete sentences? If not, describe how he/she speaks: Does the child have difficulty pronouncing words? If so, Explain: Does your child follow your directions? Please provide an example. Has the child s speech development been different from other children you have known? If so, explain: Reading and Writing (If age appropriate please complete) Has the child had any problems learning to read? Learning to write? If so, explain: 6
13 Do you read to your child? Does your child enjoy being read to? Does the child know his/her alphabet? Can the child write well for his/her age? If not, explain: Math Has the child had difficulty learning math? If so, explain: Does the child find rote learning or problem solving easier? Cognitive Development Which toys did your child pay with at age months? months? Does the child seem to learn quickly? slowly? Is he/she an average learner? Does the child have difficulty making judgments? Solving everyday problems? Reasoning? If so, explain: Educational History Where does your child attend school? What grade does your child attend? Has the child had any problems in school? making friends? If so, explain: Has his/her teachers had any complaints? If so, explain: 7
14 Is there anything else we should know about your child that is not asked here? 8
Parent Information Welcome to the San Diego State University Community Reading Clinic
Parent Information Welcome to the San Diego State University Community Reading Clinic Who Are We? The San Diego State University Community Reading Clinic (CRC) is part of the SDSU Literacy Center in the
More informationAnyone with questions is encouraged to contact Athletic Director, Bill Cairns; Phone him at or
SKYLINE GRIZZLIES ATHLETIC REQUIREMENTS and REGISTRATION FORMS 2017-18 According to School District #91 and Idaho High School Activities Association rules, all students interested in participating in athletics
More informationParticipant Application & Information
. Participant Application & Information Dear Parents and Caregivers, Thank you for your interest in the special programs we provide at Island Dolphin Care. We are excited to share with you our programs
More informationEnrollment Forms Packet (EFP)
Enrollment Forms Packet (EFP) Based on r student(s) grade and applicable circumstances, complete one enrollment package and review the information below to determine what should submit for each student
More informationAttach Photo. Nationality. Race. Religion
Attach Photo (FOUR copies of recent passport-sized photos) PC S/N C/N Class F/W For Office Use Date of Registration (dd/mm/yy) Year of Admission Programme - Primary 1 2 3 4 5 6 (circle the programme the
More informationClinical Review Criteria Related to Speech Therapy 1
Clinical Review Criteria Related to Speech Therapy 1 I. Definition Speech therapy is covered for restoration or improved speech in members who have a speechlanguage disorder as a result of a non-chronic
More informationHiSET TESTING ACCOMMODATIONS REQUEST FORM Part I Applicant Information
Part I Applicant Information Instructions: Complete this entire form. Be sure to sign the Applicant s Verification Statement on the next page. Applicant s Name (please print leave one blank box between
More information2017 High School Summer School for Current 8 th 11 th Graders
2017 High School Summer School for Current 8 th 11 th Graders Original Credit Application Due: May 5, 2017 Grade/Credit Recovery Application Due: May 26, 2017 Locations Due to construction at Morro Bay
More informationThe Foundation Academy
The Foundation Academy 3675 San Pablo Road South, Jacksonville, FL 32224 PH (904) 493-7300 FAX (904) 821-1247 www.foundationacademy.com Application for Admission School Year 2014-2015 Enrollment is capped
More informationSpecial Diets and Food Allergies. Meals for Students With 3.1 Disabilities and/or Special Dietary Needs
Special Diets and Food Allergies Meals for Students With 3.1 Disabilities and/or Special Dietary Needs MEALS FOR STUDENTS WITH DISABILITIES AND/OR SPECIAL DIETARY NEEDS Nutrition Services has a policy
More informationNew Student Application. Name High School. Date Received (official use only)
New Student Application Name High School Date Received (official use only) Thank you for your interest in Project SEARCH! By completing the attached application materials, you are taking the next step
More informationGlenn County Special Education Local Plan Area. SELPA Agreement
Page 1 of 10 Educational Mental Health Related Services, A Tiered Approach Draft Final March 21, 2012 Introduction Until 6-30-10, special education students with severe socio-emotional problems who did
More informationPRESCHOOL/KINDERGARTEN QUESTIONNAIRE
Preschool/Kindergarten Questionnaire Page 1 of 5 PRESCHOOL/KINDERGARTEN QUESTIONNAIRE Child s name: Birth date: Parent/Guardian: To the teacher: Your careful completion of this questionnaire, which will
More informationFort Lauderdale Conference
Our Mission At Social Thinking, our mission is to help people develop their social competencies to better connect with others and live happier, more meaningful lives. We create unique treatment frameworks
More informationALL DOCUMENTS MUST BE MAILED/SUBMITTED TOGETHER
LOUISIANA BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY 37283 SWAMP ROAD, SUITE 3B PRAIRIEVILLE, LOUISIANA 70769 PHONE: (225) 313-6358 or (800) 246-6050 WWW.LBESPA.ORG licensure renewal
More informationHIGH SCHOOL PREP PROGRAM APPLICATION For students currently in 7th grade
HIGH SCHOOL PREP PROGRAM APPLICATION For students currently in 7th grade APPLICATION CHECKLIST: Applications can be mailed, faxed, or dropped off to the address below. Proof of Income (Household income
More informationSTUDENT HANDBOOK ACCA
STUDENT HANDBOOK ACCA 2016-2017 1 Welcome note Dear ACCA Students, Thank you for choosing to study towards your ACCA qualification with Career Enhancement Centre (CEC) a division of City University College
More informationSupervision & Training
Supervision & Training Section 7 7-0 Revision date: September 9, 2008 Policy No. 7.01 Guiding Principles: The training program will have a mission and a philosophy of training that will provide the guiding
More informationDates and Prices 2016
Dates and Prices 2016 ICE French Language Courses www.ihnice.com 27, Rue Rossini - 06000 Nice - France Phone: +33(0)4 93 62 60 62 / Fax: +33(0)4 93 80 53 09 E-mail: info@ihnice.com 1 FRENCH COURSES - 2016
More informationBoys & Girls Club of Pequannock 2017 Summer Camp Registration COMPLETE BOTH SIDES
Boys & Girls Club of Pequannock 2017 Summer Camp Registration COMPLETE BOTH SIDES Child s Name: Date of Birth: Address: Age: Gender: City: State: Zip: Grade in Sept 17 : Home Phone: Emergency Phone: T-Shirt
More informationInterview Contact Information Please complete the following to be used to contact you to schedule your child s interview.
Cabarrus\Kannapolis Early College High School Interview Contact Information Please complete the following to be used to contact you to schedule your child s interview. Student Name Student Number Middle
More information2 months: Social and Emotional Begins to smile at people Can briefly calm self (may bring hands to mouth and suck on hand) Tries to look at parent
2 months: Begins to smile at people Can briefly calm self (may bring hands to mouth and suck on hand) Tries to look at parent Coos, makes gurgling sounds Turns head toward sounds Pays attention to faces
More informationREG. NO. 2010/003266/08 SNAP EDUCATION (ASSOCIATION INC UNDER SECTION 21) PBO NO PROSPECTUS
REG. NO. 2010/003266/08 SNAP EDUCATION (ASSOCIATION INC UNDER SECTION 21) PBO NO. 930035281 PROSPECTUS Member: Mrs AM Van Rijswijk Principal +27 (0)83 236 1766 9 De Dam St, Vierlanden, Durbanville, 7550
More informationOccupational Therapy and Increasing independence
Occupational Therapy and Increasing independence Kristen Freitag OTR/L Keystone AEA kfreitag@aea1.k12.ia.us This power point will match the presentation. All glitches were worked out. Who knows, but I
More informationPierce County Schools. Pierce Truancy Reduction Protocol. Dr. Joy B. Williams Superintendent
Pierce County Schools Pierce Truancy Reduction Protocol 2005 2006 Dr. Joy B. Williams Superintendent Mark Dixon Melvin Johnson Pat Park Ken Jorishie Russell Bell 1 Pierce County Truancy Reduction Protocol
More informationFACULTY OF ARTS & EDUCATION
FACULTY OF ARTS & EDUCATION GUIDE TO PROFESSIONAL EXPERIENCE PLACEMENT EPT326: EARLY CHILDHOOD PROFESSIONAL PRACTICE This Guide applies to students completing EPT326 within the course Bachelor of Education
More informationMONTPELLIER FRENCH COURSE YOUTH APPLICATION FORM 2016
EIL Intercultural Learning 1 Empress Place, Summerhill North, Cork, Ireland Tel: +353 (0) 21 4551535 Fax: +353 (0) 21 4551587 info@studyabroad.ie www.studyabroad.ie www.volunteerabroad.ie a not-for-profit
More informationEmergency Medical Technician Course Application
Community Health Network Emergency Medical Technician Course Application January 2018 First day of Class January 8,2018 EMERGENCY MEDICAL SERVICES & EDUCATION Thank you for your consideration in choosing
More informationChapter 9: Conducting Interviews
Chapter 9: Conducting Interviews Chapter 9: Conducting Interviews Chapter Outline: 9.1 Interviewing: A Matter of Styles 9.2 Preparing for the Interview 9.3 Example of a Legal Interview 9.1 INTERVIEWING:
More informationSchock Financial Aid Office 030 Kershner Student Service Center Phone: (610) University Avenue Fax: (610)
Schock Financial Aid Office 030 Kershner Student Service Center Phone: (610) 436-2627 25 University Avenue Fax: (610) 436-2574 West Chester, PA 19383 E-Mail: finaid@wcupa.edu Title IV Federal Student Aid
More informationGraduate Student Grievance Procedures
Graduate Student Grievance Procedures The following policy and procedures regarding non-grade grievances by graduate students can be adopted or adapted in whole or in part by programs/schools/departments
More information2. CONTINUUM OF SUPPORTS AND SERVICES
Continuum of Supports and Services 2. CONTINUUM OF SUPPORTS AND SERVICES This section will review a five-step process for accessing supports and services examine each step to determine who is involved
More informationAttendance. St. Mary s expects every student to be present and on time for every scheduled class, Mass, and school events.
Attendance ATTENDANCE PHONE NUMBER (24 HOURS) (248) 755-6376 St. Mary s expects every student to be present and on time for every scheduled class, Mass, and school events. Attendance is taken daily in
More informationPlease complete these two forms, sign them, and return them to us in the enclosed pre paid envelope.
Anatomical Donation Program Jack and Pearl Resnick Campus 1300 Morris Park Avenue, Rm F627N Bronx, NY 10461 Phone: 718.430.3142 Fax: 718.430.8997 anatomical.gifts@einstein.yu.edu We sincerely thank you
More informationTRINITY GRAMMAR SCHOOL, KEW CRICOS PROVIDER CODE 00350M INTERNATIONAL STUDENT ORIENTATION HANDBOOK
TRINITY GRAMMAR SCHOOL, KEW CRICOS PROVIDER CODE 00350M INTERNATIONAL STUDENT ORIENTATION HANDBOOK CONTENTS Welcome to Trinity Grammar School, Kew.. 3 Location, School Population, School Hours, Coordinate
More informationWhite Mountains. Regional High School Athlete and Parent Handbook. Home of the Spartans. WMRHS Dispositions
White Mountains WMRHS Dispositions Grit Self Regulation Zest Social Intelligence Gratitude Optimism Curiosity Regional High School Athlete and Parent Handbook "Don't measure yourself by what you have accomplished,
More informationCLASS EXPECTATIONS Respect yourself, the teacher & others 2. Put forth your best effort at all times Be prepared for class each day
CLASS EXPECTATIONS 1. Respect yourself, the teacher & others Show respect for the teacher, yourself and others at all times. Respect others property. Avoid touching or writing on anything that does not
More informationNATIVE VILLAGE OF BARROW WORKFORCE DEVLEOPMENT DEPARTMENT HIGHER EDUCATION AND ADULT VOCATIONAL TRAINING FINANCIAL ASSISTANCE APPLICATION
NATIVE VILLAGE OF BARROW WORKFORCE DEVLEOPMENT DEPARTMENT HIGHER EDUCATION AND ADULT VOCATIONAL TRAINING FINANCIAL ASSISTANCE APPLICATION To better assist our Clients, here is a check off list of the following
More informationESL Summer Camp: June 18 July 27, 2012 Homestay Application (Please answer all questions completely)
ESL Summer Camp: June 18 July 27, 2012 Homestay Application (Please answer all questions completely) Family Name (Surname) First Name (Given name) Applicant s Complete Address Male: Female: REGISTRATION
More informationLION KING, Jr. CREW PACKET
LION KING, Jr. CREW PACKET CHECKLIST FOR CREW SIGN-UP FOR Lion King, Jr. Please be sure to bring the following materials from this packet, completed and signed, to the crew sign-up in the WJHS auditorium
More informationMedical College of Wisconsin and Froedtert Hospital CONSENT TO PARTICIPATE IN RESEARCH. Name of Study Subject:
IRB Approval Period: 03/21/2017 Medical College of Wisconsin and Froedtert Hospital CONSENT TO PARTICIPATE IN RESEARCH Name of Study Subject: Comprehensive study of acute effects and recovery after concussion:
More informationACCE. Application Fall Academics, Community, Career Development and Employment Program. Name. Date Received (official use only)
ACCE Academics, Community, Career Development and Employment Program Application Fall 2017 Name Date Received (official use only) PROGRAM DESCRIPTION Easterseals Arkansas (ESA) and the University of Arkansas
More informationIntroduction to Psychology
Course Title Introduction to Psychology Course Number PSYCH-UA.9001001 SAMPLE SYLLABUS Instructor Contact Information André Weinreich aw111@nyu.edu Course Details Wednesdays, 1:30pm to 4:15pm Location
More informationAccommodation for Students with Disabilities
Accommodation for Students with Disabilities No.: 4501 Category: Student Services Approving Body: Education Council, Board of Governors Executive Division: Student Services Department Responsible: Student
More informationKannapolis City Schools 100 DENVER STREET KANNAPOLIS, NC
POSITION Kannapolis City Schools 100 DENVER STREET KANNAPOLIS, NC 28083-3609 QUALIFICATIONS 704-938-1131 FAX: 704-938-1137 http://www.kannapolis.k12.nc.us HMResources@vnet.net SPEECH-LANGUAGE PATHOLOGIST
More informationCLASSROOM PROCEDURES FOR MRS.
CLASSROOM PROCEDURES FOR MRS. BURNSED S 7 TH GRADE SCIENCE CLASS PRIDE + RESPONSIBILTY + RESPECT = APRENDE Welcome to 7 th grade Important facts for Parents and Students about my classroom policies Classroom
More informationTOEIC Bridge Test Secure Program guidelines
TOEIC Bridge Test Secure Program guidelines Notes on application Please confirm and consent to the Privacy Policy of IIBC and TOEIC Bridge Test Secure Program guidelines before you apply for the TOEIC
More informationUW-Waukesha Pre-College Program. College Bound Take Charge of Your Future!
UW-Waukesha Pre-College Program College Bound 2017 Take Charge of Your Future! This is a great program to increase your knowledge on various subjects. Students will be engaged in workshops and hands-on
More informationUpward Bound Math & Science Program
Upward Bound Math & Science Program A College-Prep Program sponsored by Northern Arizona University New for Program Year 2015-2016 Students participate year-round each year beginning in 2016 January May
More informationR. E. FRENCH FAMILY EDUCATIONAL FOUNDATION
R. E. FRENCH FAMILY EDUCATIONAL FOUNDATION SCHOLARSHIP APPLICATION The R. E. French Family Educational Foundation was created by the R. E. French Family to provide scholarships for high school graduates
More informationThe Tutor Shop Homework Club Family Handbook. The Tutor Shop Mission, Vision, Payment and Program Policies Agreement
The Tutor Shop Homework Club Family Handbook The Tutor Shop Mission, Vision, Payment and Program Policies Agreement Our Goals: The Tutor Shop Homework Club seeks to provide after school academic support
More informationCIN-SCHOLARSHIP APPLICATION
CATAWBA INDIAN NATION SCHOLARSHIP COMMITTEE 2014-2015 CIN-SCHOLARSHIP APPLICATION The Catawba Indian Nation Higher Education Scholarship Committee Presents: THE CATAWBA INDIAN NATION SCHOLARSHIP PROGRAM
More informationDOCENT VOLUNTEER EDUCATOR APPLICATION Winter Application Deadline: April 15, 2013
DOCENT VOLUNTEER EDUCATOR APPLICATION Winter 2013 Application Deadline: April 15, 2013 We appreciate your interest in the VBMA Docent Program! Last year docents provided more than 5,700 volunteer hours,
More informationSpeech/Language Pathology Plan of Treatment
Caring for Your Quality of Life Patient s Last Name First Name MI HICN Speech/Language Pathology Plan of Treatment Provider Name LifeCare of Florida Primary Diagnosis(es) Provider No Onset Date SOC Date
More informationUNIVERSITY OF MARYLAND DEPARTMENT OF HEARING AND SPEECH SCIENCES MA PROGRAM AND SPEECH LANGUAGE PATHOLOGY GUIDELINES FOR COMPREHENSIVE EXAMINATIONS
UNIVERSITY OF MARYLAND DEPARTMENT OF HEARING AND SPEECH SCIENCES MA PROGRAM AND SPEECH LANGUAGE PATHOLOGY GUIDELINES FOR COMPREHENSIVE EXAMINATIONS Effective Spring 2010 Contents When am I eligible to
More informationEL RODEO SCHOOL VOLUNTEER HANDBOOK
EL RODEO SCHOOL VOLUNTEER HANDBOOK WELCOME TO EL RODEO! WHY VOLUNTEER? The success of El Rodeo School is dependent upon the partnership between teachers, students, and parents. We need volunteers for many
More informationPractice Learning Handbook
Southwest Regional Partnership 2 Step Up to Social Work University of the West of England Holistic Assessment of Practice Learning in Social Work Practice Learning Handbook Post Graduate Diploma in Social
More informationSpecialized Equipment Amount (SEA)
A Guide for Parents, Guardians and Students Specialized Equipment Amount (SEA) The Special Equipment Amount (SEA) provides funding to school boards to assist with the costs of equipment essential to support
More informationINDEPENDENT STUDY PROGRAM
INSTRUCTION BOARD POLICY BP6158 INDEPENDENT STUDY PROGRAM The Governing Board authorizes independent study as a voluntary alternative instructional setting by which students may reach curricular objectives
More informationStatement on short and medium-term absence(s) from training: Requirements for notification and potential impact on training progression for dentists
Statement on short and medium-term absence(s) from training: Requirements for notification and potential impact on training progression for dentists and doctors Definition Time out of training in this
More informationCOURSE SYLLABUS for PTHA 2250 Current Concepts in Physical Therapy
COURSE SYLLABUS for PTHA 2250 Current Concepts in Physical Therapy CATALOGUE DESCRIPTION Current concepts, skills, and knowledge in the provision of physical therapy services. Includes enhancement of professional
More informationGuidelines for Completion of an Application for Temporary Licence under Section 24 of the Architects Act R.S.O. 1990
Guidelines for Completion of an Application for Temporary Licence under Section 24 of the Architects Act R.S.O. 1990 OAA-12-16 1 INDEX Page Number General... 3 Fees for Temporary Licence... 4 Appendix
More informationThomas Jefferson University Hospital. Institutional Policies and Procedures For Graduate Medical Education Programs
Thomas Jefferson University Hospital Institutional Policies and Procedures For Graduate Medical Education Programs Table of Contents Dispute Resolution Procedure 1 Duty Hours 2 Duty Hours Requests for
More informationExaminee Information. Assessment Information
A WPS TEST REPORT by Patti L. Harrison, Ph.D., and Thomas Oakland, Ph.D. Copyright 2010 by Western Psychological Services www.wpspublish.com Version 1.210 Examinee Information ID Number: Sample-02 Name:
More informationUNIVERSITY OF NORTH ALABAMA DEPARTMENT OF HEALTH, PHYSICAL EDUCATION AND RECREATION. First Aid
UNIVERSITY OF NORTH ALABAMA DEPARTMENT OF HEALTH, PHYSICAL EDUCATION AND RECREATION COURSE NUMBER: HPE 233 COURSE TITLE: First Aid SEMESTER HOURS: 3 semester hours PREREQUISITES: None REVISED: January
More informationDuke University. Trinity College of Arts & Sciences/ Pratt School of Engineering Application for Readmission to Duke
Office Use Only Durham, North Carolina Application Fee $30 received Trinity College of Arts & Sciences/ Pratt School of Engineering Application for Readmission to Duke BEFORE completing this application,
More informationDear Internship Supervisor:
Dear Internship Supervisor: Thank you for agreeing to supervise the internship of a Hunter College Geography student. I hope that this arrangement will benefit both your organization and our student. Student
More informationStudy Abroad Application Vietnam and Cambodia Summer 2017
Study Abroad Application Vietnam and Cambodia Summer 2017 Program: COM 220: Storytelling Then and Now Vietnam and Cambodia Course Dates: 5/24/17 7/20/17; Trip Dates 6/16/17 7/3/17 Information meetings
More informationPsychology 102- Understanding Human Behavior Fall 2011 MWF am 105 Chambliss
Psychology 102- Understanding Human Behavior Fall 2011 MWF 9.00 9.50 am 105 Chambliss Instructor: April K. Dye, Ph.D. E-mail: adye@cn.edu Office: 208 Chambliss; Office phone: 2086 Office Hours: Monday:
More informationMEDICAL ACUPUNCTURE FOR VETERINARIANS
MEDICAL ACUPUNCTURE FOR VETERINARIANS Center for Comparative and Integrative Pain Medicine Merging Modern Medicine with Ancient Wisdom Course Information Why Medical Acupuncture for Veterinarians? Medical
More informationCurriculum Vitae of. JOHN W. LIEDEL, M.D. Developmental-Behavioral Pediatrician
Updated July 07, 2009 of JOHN W. LIEDEL, M.D. Developmental-Behavioral Pediatrician EDUCATIONAL AND PROFESSIONAL EXPERIENCE: Children's Program 7707 SW Capitol Hwy. 97219 August 1987 - Present The Children's
More informationLesson Plan. Preparation
General Housekeeping: Forms Practicum in Fashion Design Lesson Plan Performance Objective Upon completion of this lesson, each student will demonstrate the characteristics necessary to be a successful
More informationPROGRAM REQUIREMENTS FOR RESIDENCY EDUCATION IN DEVELOPMENTAL-BEHAVIORAL PEDIATRICS
In addition to complying with the Program Requirements for Residency Education in the Subspecialties of Pediatrics, programs in developmental-behavioral pediatrics also must comply with the following requirements,
More informationMADISON METROPOLITAN SCHOOL DISTRICT
MADISON METROPOLITAN SCHOOL DISTRICT Section 504 Manual for Identifying and Serving Eligible Students: Guidelines, Procedures and Forms TABLE OF CONTENTS INTRODUCTION. 1 OVERVIEW.. 2 POLICY STATEMENT 3
More informationCOMMUNITY RESOURCES, INC.
COMMUNITY RESOURCES, INC. 3245 E. Exposition Ave Denver, Colorado 80209 Voice: 720-424-2300 Fax: 720-424-2301 Website: www.communityresourcesinc.org ACADEMIC MENTORS PROJECT STUDENT NOMINATION FORM (P.
More informationGERM 3040 GERMAN GRAMMAR AND COMPOSITION SPRING 2017
GERM 3040 GERMAN GRAMMAR AND COMPOSITION SPRING 2017 Instructor: Dr. Claudia Schwabe Class hours: TR 9:00-10:15 p.m. claudia.schwabe@usu.edu Class room: Old Main 301 Office: Old Main 002D Office hours:
More informationSpring 2015 CRN: Department: English CONTACT INFORMATION: REQUIRED TEXT:
Harrisburg Area Community College Virtual Learning English 104 Reporting and Technical Writing 3 credits Spring 2015 CRN: 32330 Department: English Instructor: Professor L.P. Barnett Office Location: York
More informationSchool Participation Agreement Terms and Conditions
School Participation Terms and Conditions For schools enrolling students into online IB Diploma Programme courses This is a contract where it is agreed as follows: 1. Interpretations and Definitions The
More informationDEPARTMENT OF KINESIOLOGY AND SPORT MANAGEMENT
DEPARTMENT OF KINESIOLOGY AND SPORT MANAGEMENT Undergraduate Sport Management Internship Guide SPMT 4076 (Version 2017.1) Box 43011 Lubbock, TX 79409-3011 Phone: (806) 834-2905 Email: Diane.nichols@ttu.edu
More informationPractice Learning Handbook
Southwest Regional Partnership 2 Step Up to Social Work University of the West of England Holistic Assessment of Practice Learning in Social Work Practice Learning Handbook Post Graduate Diploma in Social
More information20 HOURS PER WEEK. Barcelona. 1.1 Intensive Group Courses - All levels INTENSIVE COURSES OF
Barcelona 2014 1.1 Intensive Group Courses - All levels These courses consist of 4 hours tuition per day, from 09.30 to 13.30, Monday to Friday. The average number of students per group is 7 and there
More informationCambridgeshire Community Services NHS Trust: delivering excellence in children and young people s health services
Normal Language Development Community Paediatric Audiology Cambridgeshire Community Services NHS Trust: delivering excellence in children and young people s health services Language develops unconsciously
More informationEnglish Grammar and Usage (ENGL )
Dr. Chris Healy HLG 250 482-5476 healy@louisiana.edu English Grammar and Usage (ENGL 352-002) Office Hours MWF 10:00 11:00 MW 1:00 2:30 and by appointment Spring 2015 MWF 11:00 11:50 a.m. HLG 131 COURSE
More informationSANTA CLARA COUNTY OFFICE OF EDUCATION Personnel Commission
SANTA CLARA COUNTY OFFICE OF EDUCATION Personnel Commission CLASS TITLE: Paraeducator-Special Education DESCRIPTION OF BASIC FUNCTION AND RESPONSIBILITIES To assist teacher(s) and/or other certificated
More informationFUNCTIONAL BEHAVIOR ASSESSMENT
FUNCTIONAL BEHAVIOR ASSESSMENT Student Name: School: Grade: Date completed: Participants in developing plan: School Administrator: Parent/Guardian: General Education Teacher: Behavioral Consultant: School
More informationInstructions & Application
2015-2016 St. Philip the Deacon Seminarian Scholarship Program Instructions & Application The John C. Kulis Charitable Foundation, a 501(c)(3) non-profit foundation, is commonly known as the Kulis Foundation.
More informationWashington Homeschool Organization
Washington Homeschool Organization 2016 Sumner, WA Graduation Information Packet General Information Where & when will the commencement ceremony be held? The Graduating Class of 2016 will receive their
More informationTamwood Language Centre Policies Revision 12 November 2015
Do More, Learn More, BE MORE! By teaching, coaching and encouraging our students, Tamwood Language Centres helps students to develop their talents, achieve their educational goals and realize their potential.
More informationBrief Home-Based Data Collection of Low Frequency Behaviors
Georgia Southern University Digital Commons@Georgia Southern Georgia Association for Positive Behavior Support Conference Dec 4th, 9:45 AM - 10:45 AM Brief Home-Based Data Collection of Low Frequency Behaviors
More informationTRANSFER APPLICATION: Sophomore Junior Senior
: Sophomore Junior Senior 2714 W Augusta Phone: 773.534.9718 Fax: 773.534.4022 Email: admissions@chiarts.org Web: www.chiarts.org CPS Mail Run: G.S.R. #35 FRESHMAN APPLICATION STEPS Thank you for your
More informationRequired Materials: The Elements of Design, Third Edition; Poppy Evans & Mark A. Thomas; ISBN GB+ flash/jump drive
ARV 121 introduction to design DIGITAL ARTS INSTRUCTIONAL PACKAGE ARV 121 Course Prefix and Number: ARV 121 Course Title: Introduction to Design Lecture Hours: 3 Professor: Office Hours: Catalogue Description:
More informationClass Schedule
Reach for a Star Effort Purpose Potential Dreams Relationship Ability Creativity Vision Commitment Celebrating 37 Years Come to The Center and be yourself! 2017-2018 Class Schedule Mission Statement The
More informationARKANSAS TECH UNIVERSITY
ARKANSAS TECH UNIVERSITY Procurement and Risk Management Services Young Building 203 West O Street Russellville, AR 72801 REQUEST FOR PROPOSAL Search Firms RFP#16-017 Due February 26, 2016 2:00 p.m. Issuing
More informationADULT VOCATIONAL TRAINING (AVT) APPLICATION
Attention Education Department AVT 2468 West 11 th Eugene, OR 97402 ADULT VOCATIONAL TRAINING (AVT) APPLICATION The following documents or information will be required to complete the application: Documents
More informationOccupational Therapist (Temporary Position)
Edmonton Catholic Schools is now accepting applications for the position of Occupational Therapist (Temporary Position) Edmonton Catholic Schools is a large urban school district whose mission is to provide
More informationPlainfield High School Central Campus W. Fort Beggs Drive Plainfield, IL 60544
Plainfield High School Central Campus 24120 W. Fort Beggs Drive Plainfield, IL 60544 District 202 High School Summer School 2017 Session I Wednesday, June 7 Thursday, June 29, 2017 Session II Wednesday,
More informationPhase 3 Standard Policies and Procedures
Phase 3 Standard Policies and Procedures 2015 2016 The third year of the curriculum is one of the most exciting years of your medical education because it is the first real opportunity for you to be directly
More informationCrestdale Middle School We Dare To Be Great. A North Carolina School to Watch Rhonda Houston Principal
Crestdale Middle School We Dare To Be Great A North Carolina School to Watch Rhonda Houston Principal Student Handbook 2010-2011 940 Sam Newell Road Matthews, NC 28105 Office: 980-343-5755 Fax: 980-343-5761
More informationGraduate Student Travel Award
Minimum Requirements for Eligibility: Graduate Student Travel Award 2016-2017 The applicant must provide travel-related information in a timely basis to the administrative staff and complete the UTRGV
More informationYouth Apprenticeship Application Packet Checklist
Youth Apprenticeship Application Packet Checklist Incomplete applications will not be forwarded to hiring companies and will delay the application process. A complete application packet should consist
More information