Empowered Voice Rehabilitation SLP Graduate Student Application

Empowered Voice Rehabilitation SLP Graduate Student Clinician Application

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Education
Undergraduate
Graduate
Skills & Training
Training or Certifications:
Practicum
Why are you applying for this clinical practicum?

Rank your comfort level with evaluation in the following clinical areas of speech-language pathology.

Rows	Independent	Needs minimal support	Needs moderate support	Needs maximum support	No experience
Aphasia
Cognitive-Linguistic Disorders
Motor Speech Disorders
Dysphagia
Voice & Upper Airway Disorders
Augmentative & alternative communication
FEES
Videostroboscopy

Rank your comfort level with treatment in the following clinical areas of speech-language pathology.

Rows	Independent	Needs minimal support	Needs moderate support	Needs maximum support	No experience
Aphasia
Cognitive-Linguistic Disorders
Motor Speech Disorders
Dysphagia
Voice & Upper Airway Disorders
Augmentative & alternative communication

Practicum Availability
Anticipated start date for practicum

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Anticipated end date for practicum

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please select your availability for this practicum.
List any dates that you know you will be unavailable during this practicum period:
Problem Solving Scenarios

Please answer the following questions.
Explain the steps you would take to complete a clinical "bedside" swallow evaluation from start to finish.
You are conducting a LOUD Crowd® group maintenance session for patients with Parkinson's disease. Provide one example of a cognitive-linguistic task that you could utilize during this group session. Tell me how you would modify this task for a patient who has a mild cognitive-linguistic impairment and how you would modify the same task for a patient who has a severe cognitive-linguistic impairment.
Information provided by your supervisor conflicts with information presented in one of your classes. How do you address this situation?
Professional References

Please list two (2) references that are familiar with your work life and/or school work.
Reference 1
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example@example.com
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Reference 2
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Email
example@example.com
Years Known:
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