Observation Request Form

If you are interested in observing a speech-language pathologist or audiologist at Boston Children's Hospital, please complete the following form. Observations cannot exceed 3 days. Please note that we receive several requests for observation and have limited space to accommodate observers. Requesting an observation slot does not guarantee you will be able to observe. YOU WILL ONLY BE CONTACTED IF YOUR REQUEST IS APPROVED. IF YOU DO NOT HEAR FROM US WITHIN 2 WEEKS, WE WERE NOT ABLE TO ACCOMMODATE YOUR REQUEST.

Phone
How do you prefer we contact your
Which program you would like to observe?*

If you are unfamiliar with our programs, please visit our CCE website for program descriptions.

The program you have selected has clinic at the following location(s). Please check to confirm which locations you can travel to.

Check all that apply