Kentucky Speech-Language-Hearing Association » KSHA-ASHF Clinical Achievement Award Nominations

KSHA-ASHF Clinical Achievement Award Nominations Form

This award is presented to a speech-language pathologist or audiologist in Kentucky for demonstrated contributions to the advancement of knowledge in clinical practice. Significant recent accomplishments must have been completed within the past six years in either area. This award is co-sponsored by the Kentucky Speech-Language-Hearing Association (KSHA) and the American Speech-Language-Hearing Foundation (ASHF).

Nominations received by December 15 will be considered for the KSHA-ASHF Clinical Achievement Award.

Name of the person making the nomination *

Email of person making the nomination *

Name of Nominee *

Nominee\'s Credentials (ex. MS, CCC-SLP) *

Nominee\'s Email Address *

Nominee\'s Telephone Number *

Nominee\'s Workplace/Location *

Description of the outstanding clinical achievement (include information of when and where the specific achievement(s) took place) *

Description of the significance of the recent achievement *

Explanation of how the nominee’s actions have advanced knowledge in the area of clinical practice *

Explanation of the nominee’s role in the achievement *

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KSHA-ASHF Clinical Achievement Award Nominations

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