Speech Pathology Scope of Practice Questionnaire

* Age:

* Sex:

Female

Male

* Profession:

Occupational Therapist

Otorhinolaryngologist

Physical Therapist

Special Education Teacher

* Area of Residence:

* Area of Work Place:

* Work Setting: (check all applicable)

* Number of years of practice:

* Number of years working with a Speech Pathologist (SP):

* Total number of clients referred to a SP:

Total number of clients managed with a SP, including who were discharged: