CERTIFICATION
OF
UNDER THE DIRECTION AND ACCESSIBILITY

I, ___________________________________, CCC-SLP, NYS Licensed and Registered (updated 2/6/07) Speech-Language Pathologist, with current license number_____________________________________ certify that I am providing "Under the Direction" (attached) services to the following Certified Teachers of the Speech and Hearing Handicapped (Therapist):

Name of Therapist

I am providing accessibility to the Teachers of the Speech and Hearing Handicapped in the following manner:

_______________________________________________ ________________________________

Signature of Licensed Speech/Language Pathologist Date

C-11