Emily Hathaway, M.S. CCC-SLP & Associates
Certified, Licensed Speech-Language Pathologists
6905 NW 122nd Street OKC OK 73142
Phone: (405) 603-6622
Fax: (405) 722-3244
In consideration of treatment and education purposes, I give consent that sound recording, record, and/or photographs may be used as deemed helpful by Speech Pathway. This form has been fully explained to me/us and I/we understand the contents.