Speech-Language and Hearing Clinic

The UNL Barkley Speech-Language and Hearing Clinic is located in the Barkley Memorial Center on the University of Nebraska-Lincoln's East Campus at 42nd and Holdrege Streets.

Audiology (hearing) patients, please fill out forms as directed before your visit. If you have questions, you may call
(402) 472-2071 or 2068.

Audiology Forms For Adults - Ages 18-64

Audiology Patient Registration - Adult
Authorization for Release of Information
Adult Audiology Case History
Evaluation and Treatment Consent Form
Hearing Handicap Inventory

General Forms for all Patients and Clients
Fees and Billing Information
HIPAA Notice - Privacy Acknowledgement
HIPAA Notice
Map

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