Working Plan for: Complete the form below OR click here to download PDF version Working plan for: Taylor Perdue, SLP Jana Folmer, CHA Danielle Thomson, CDA Krystina Shaw, CDA and Cheryl D. Lindsay Speech and Language Assessment and Treatment Services for Children and Adults(Name of Third Party Delivered by) Student/Client Name:* First Last Purpose of Involvement: Select All Parental Permission in writing Qualifications checked Police Check Projected Timeline for Involvement:Dates for School Visits: Weekly Biweekly Monthly To be determined Location/Space usually used:School Name and space SummaryToday's Date Month Day Year Principal First Last Parent First Last Speech-Language Pathologist First Last Assistant-Direct Therapy First Last Form completed by:Name* First Last Email*Email will be sent to you to forward when appropriate to: Parent/OSE/Third Party Enter Email Confirm Email CAPTCHA