Client Application
Welcome to the Ludden Speech and Language Clinic. Thank you for inquiring about our 服务. In order to submit an application for 服务, please completely review the Ludden Clinic Client Handbook (英语/西班牙语) and complete the case history, diagnostic request, and registration forms.
Saint Xavier University
Ludden Speech and Language Clinic
3700 W. 103rd Street
Chicago, IL 60655
Please mail the following forms:
- The following forms must be filled out completely. Be sure to include a description of speech and language difficulties.
- A diagnostic request form so that an evaluation may be arranged at a mutually agreeable
time.
- Diagnostic Request Form (PDF)
- A completed Registration Form (英语/西班牙语).
- A completed Audio/Video Consent Form (英语/西班牙语). As a teaching 诊所, completion of this form is required to be treated at this 诊所.
An optional Consent to Obtain or Furnish Patient Information Form (英语/西班牙语) is also available, if you choose to fill out and send in.
我们的 诊所 provides learning opportunities for SXU students while servicing the community with speech and language therapy. Besides offering high quality therapy 服务, because we operate on a donation basis only without billing insurance or requiring a self-pay therapy fee we traditionally have a very long client waiting list. 我们所做的 our best to move people through the waiting list for screenings, full diagnostics 和治疗. For graduation, our students have needs to fulfill hours in all of these categories, as well as requirements to treat clients of all ages and abilities. 我们的 student enrollment and supervisory staffing fluctuates and we work on a school calendar schedule which are additional variables that impact scheduling. All of these factors make it impossible to predict how long it will take to be scheduled. We also do our best to provide continuity of care to our clients, but there is no guarantee of being scheduled each semester after starting therapy at Ludden Clinic as the educational needs of our students is our core responsibility. When we are unable to service clients in their desired timeframe, we can provide families with a list of other area providers so their therapy is not delayed. After the Clinic receives your completed paperwork and there is an opening in the 诊所 schedule, you will be contacted to arrange a time for the evaluation. If you have any questions or concerns, please feel free to contact the Clinic at 773-298-3571.
We look forward to serving you and your family.
Christopher Kolasa
Clinic Coordinator
Phone: 773-298-3571
电子邮件: ludden诊所FREESXU