Download and fill in the appropriate form and mail or fax to the Clinic. Our mailing address is on the form. For fax, send to 404-413-8046.

• Preschool Child Case History Form
• School Age Child Case History Form
• Adult Case History Form

Fees are charged at both clinic locations. Therapy fees should be paid within two weeks of service. Evaluation fees are due the day of the service.

• The Georgia State University Speech-Language-Hearing Clinic accepts cash, checks and credit cards for payment.
• We do not bill Medicare, Medicaid or private insurance. We are not a Medicare provider and do not accept Medicare patients.
• No one is denied services due to inability to pay full fees. A sliding scale is available. Please contact the clinic office at 404-413-8044 to discuss a fee adjustment.
• Clinical services are free to Georgia State University students.
• Georgia State University faculty and staff members are charged 50% of the regular fee for the service provided.
• There’s no fee to attend a support group.

Clinic Service	Fee
Therapy Registration Fee for Fall and Spring Semester	$300.00
Therapy Registration Fee for Summer Semester	$200.00
Speech-Language Evaluation	$150.00
Hearing Evaluation	$60.00
Hearing Screening	$20.00
Speech-Language Screening	$20.00