Girls filling out forms

Forms & Fees

Download and fill in the appropriate form and mail or fax to the Clinic. Our mailing address is on the form. For fax, send to 404-413-8046.

Therapy fees should be paid within two weeks of service. Evaluation fees are due the day of the service.

  • The Georgia State University Speech-Language-Hearing Clinic does not accept Medicare patients and does not bill Medicare, Medicaid or private insurance. Cash and checks are accepted for payment.
  • No one is denied services due to inability to pay full fees. A sliding scale is available. Please contact the clinic director to discuss a fee adjustment.
  • Clinical services are free to Georgia State University students.
  • Georgia State University faculty and staff members are charged 50% of the regular fee for the service provided.
Clinic Service Fee
Therapy Registration Fee for Fall and Spring Semester $300.00
Therapy Registration Fee for Summer Semester $200.00
Speech-Language Evaluation $150.00
Hearing Evaluation $60.00
Hearing Screening $20.00
Speech-Language Screening $20.00