• ABSSD Recommendation Form

    American Board of Swallowing and Swallowing Disorders

  • Dear Recommendar, Please complete the following form AND attach a narrative letter of recommendation to this form. Note: Letters need to be on letterhead and signed. Thank you.

  • For the questions below, please rate the applicant's abilities in the noted areas relative to the management of dysphagia. Please rank the applicant in relation to other individuals you have known in a similar capacity. Higher scores are to the left. Select 'Not Observed' (N/0) if you have not had an opportunity to evaluate the characteristic or have no basis for assessment.
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  • Demonstrates Leadership
  • Practices with patient-centered clinical methods
  • Manages dysphagia cases effectively
  • Communicates effectively with peers, superiors and mentees
  • Communicates effectively with non-SLP personnel
  • Communicates effectively with consumers
  • Is independent in developing/implementing dysphagia protocols
  • Is a good collaborator
  • Displays good mentoring skills
  • What is your overall estimate of the applicant as a"Dysphagia Specialist"?
  • Are you aware of any patient/consumer complaints about the applicant?
  • Please check one of the following:
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  • Date
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  • Contact the AB-SSD office with questions:

    563 Carter Court, Suite B
    Kimberly, WI 54136
    Phone: 920-560-5625
    Fax: 920-882-3655
    Email: Karen@badgerbay.co

  • American Board of Swallowing and Swallowing Disorders • 920-560-5625 • info@swallowingdisorders.org

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