Verification of Hours, Licensure, and Certification Forms

Those requesting verification of 25 hours of clinical observation for licensure by the State Board of Examiners for Speech-Language-Pathology and Audiology must submit the following to the department chair:

1. Complete hours form attached
2. Email request to cdis@txstate.edu , or

          Mail request and form to: 

          Communication Disorders      

          Texas State University 

          Willow Hall 253

          200 Bobcat Way 

          Round Rock, TX 78665

If the Name and University Name lines of the Verification of Hours Form are not completed by you, then your hours will not be processed. Enter the University name as it currently is (Texas State University), NOT as it was at the date of graduation. DO NOT ENTER SS#. The form will be returned to you, NOT submitted to the licensing board.  Thank you for your assistance in making it as easy as possible to help you in a timely manner.