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 Dr. Valarie Fleming:
- Email request to: email@example.com
- Check in the amount of $25 made payable to the CDIS Fund
- Completed hours form
- Mail check and form to:
Texas State University
601 University Dr.
San Marcos, TX 78666
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.