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Click ‘Get Form’ to open the Speech-Language Pathology Observation Hours Verification Form - bw in the editor.
Begin by entering your name in the 'Student Name' field. Ensure that your name is spelled correctly for accurate verification.
In the 'Date Range Observation Hours Were Obtained' section, specify the month and year during which you completed your observation hours.
Fill out the KASA Area sections by indicating the total hours observed for each category, such as Pediatric Evaluation, Adult Intervention, etc. Be thorough to reflect all relevant experience.
Calculate and enter the 'Total Overall Observation Hours in Speech-Language Pathology' at the end of the form.
The verifying therapist must print their name, provide their state license number and ASHA number, and sign with the date to validate your observation hours.

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