Speech and Language Therapy Consent for Assessment I

Speech and Language Therapy Consent for Assessment I am a Speech and Language Therapist. I help people with their communication. Communication means… Being able to tell people what you want and what you think being able to understand information. This information has been rated by NHS Fife, Good Information Fife Team

Speech and Language Therapy Consent for Assessment I would like to find out more about your understanding, and the things you find easy or hard. I might talk to your carers I might ask you to look at some pictures Would this be ok? Yes No

Speech and Language Therapy Consent for Assessment I would like to find out more about how you communicate I might ask you and your carers about your talking I might ask you and your carers about the signs you use I might ask you and your carers about any pictures you use Would this be ok? Yes No

Speech and Language Therapy Consent to Share Information I will write a report. I might want to tell other people about your communication and the things you find easy and hard. This is so your family, friends and carers know how to help you. Would this be ok? Yes No

Speech and Language Therapy Consent to Share Information Would it be ok for me to send my report to… Yes No Your staff Your family Your doctor Your nurse Your social worker Service user signature: ____________ Date: _______ Representative: _______ Role: _____ Date: _______ SLT: ____________________Date: _______