Pediatric Documentation Templates

The templates included here are provided as a resource only and do not represent ASHA policy. To request customizable templates in Word format, please e-mail healthservices@asha.org and indicate which templates you would like to receive. These templates were developed by a work group of affiliates from Special Interest Group 13 (Swallowing and Swallowing Disorders [Dysphagia]).

Available Templates

Feeding History and Clinical Assessment

Infants (6 months and younger) [PDF]

Children (6 months and older) [PDF]

Glossary of Terms and Conditions [PDF]

Videofluoroscopic Swallowing Studies

Infants (Consuming liquids only) [PDF]

Children (Consuming liquids and solids) [PDF]

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