Title of Program:
(limit to 70 letters/spaces)

Date(s) of Program:

Course Location: (enter City only)

Program Content Intended For:
Audiologists
Speech-Language Pathologists
Both

Presenter(s) name, affiliation, and brief
description of qualifications:
If the Presenter has previously been approved,
or if you don't know, click here to select from
a list of approved presenters.
(Limit 255 Characters)

Program Description and Overall Goal:
(why this course is needed and how it will address the need)

Educational Objectives: (To follow ASHA guidelines you must state "As a result of this presentation the participant will be able to..." Please incorporate easy to measure action verbs such as perform, identify, or list. Please do not include verbs that are difficult to measure such as understand, become familiar with, learn, or appreciate. A minimum of 3 learner objectives required.)

Instruction Method and Course Materials to be used: (lecture, powerpoint, videos, handouts, discussion, etc.)

I will use:    TSHA Evaluation Form     Our Own Evaluation Form

Please    Do   Do Not    publish in the CE Calendar

Has this program been previously approved by TSHA?
Yes    No

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