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Feeding & Swallowing Clinic
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Forms

To be filled out prior to scheduling appointment:

  • Feeding History Questionnaire (DOCX)
  • Medical Clearance Form (DOCX)

To be brought on day of appointment:

  • HIPPA (DOCX)
  • Release of Info (DOCX)
  • Media Release (PDF)
  • Diet Record (DOCX)
  • Sensory Eating Problems Scale (PDF)
  • Technical Assessment (PDF)

About Navigation

  • Day of Clinic Procedures
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  • New Appointment Process
  • What To Expect After Clinic
  • Directions to the CED
  • Contact

Cassaundra Miller
CED Feeding Clinic - Morgantown
Phone: (304) 293-4692
Email: ccorbett@hsc.wvu.edu
Fax: 888-510-3125

Disclaimer- Inclusion of resources and/or providers on our site does not imply endorsement nor does exclusion mean we do not think it is valuable. We work to keep our list of resources current and relevant but it is not exhaustive. If you have suggestions or updates, please email cedcontact@hsc.wvu.edu.

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