Language Task: Building a Medical History Form

This therapy task is designed for Speech-Language Pathologists working with people who have aphasia or other communication impairments. It is based on the PACT method, published in The ASHA Leader, March 2016.

Instructions: In a structured therapy session, complete these forms with a patient who has communication challenges before they go to doctor’s appointments. Ensure that a copy is sent with all medical appointments that the patient has scheduled.

Included in: Bundle: Aphasia.

Full access PDF is $8. Once purchased, you may save to your computer and print as many times as needed for your clinical practice.

MIX & MATCH, BUNDLE & SAVE: All Full-Access PDFs are discounted when you bundle:

• 1 for $8
• 2 for $12 ($6 each)
• 3 for $15 ($5 each)

Discount applied automatically at checkout.

If you purchase 5 color copies, 5 printed color copies will be delivered to your mailbox. Does not include access to PDF file.

Please note that PDFs are not easily opened, saved, or manipulated on phones or tablets. We recommend only downloading on a computer after purchase. Digital download links will be available after payment on the checkout page and in your order confirmation via email. You will have 5 download attempts over 1 month to access the file. Only the purchaser may access and use the file for their own clinical practice.

It is ok to:

• Share a printed copy of this resource with a patient/client, their family members and friends, and non-SLP/OT/PT related staff such as nursing, home healthcare providers, physicians, CNAs, social services, dietitians, activities teams, teachers, caregivers, etc.
• Digitally share the file via online, secure, HIPAA-compliant teletherapy software platforms to any of the people listed in the above point in the context of teletherapy.
  

It is not ok to:

• Share any digital copy with clients outside of the context of teletherapy.
• Store these files in any publicly accessible online storage system, such as a shared Google drive or other online storage service.
• To share these files with other SLP/OT/PT related colleagues or friends. Please refer, don’t share.

Tech specs: Digital download. 7 pages. 8.5 x 11 inches. PDF format. 110 kb.