Speech Therapy Success Stories: Patient Testimonial Template

Patient Information Section

• First Name (or initials for privacy): _______________
• Age Group: □ Child (3-12) □ Teen (13-17) □ Adult (18+)
• Primary Condition: _______________

Treatment Journey

Initial Challenges

"Before starting speech therapy at [Practice Name], I/my child struggled with..." [Provide space for specific challenges, such as:

• Articulation difficulties
• Fluency issues
• Voice disorders
• Language delays]

Treatment Experience

"During my/my child's treatment journey..."

• Length of treatment: _______________
• Frequency of sessions: _______________
• Specific techniques that helped: _______________

Measurable Improvements

"After working with [Therapist's Name], I/my child can now..." [Document specific achievements, such as:

• Improved pronunciation of specific sounds
• Enhanced communication in social settings
• Better classroom participation]

Personal Impact Statement

"The most significant change in my/my child's life has been..."

Professional Care Experience

"What I appreciated most about [Practice Name] was..."

• Staff interactions
• Facility environment
• Treatment approach

Consent Section

I, _____________, give permission to [Practice Name] to use this testimonial for:

• □ Website content
• □ Social media
• □ Print materials
• □ Educational presentations

Signature: _______________ Date: _______________

Note: This template should be customized to comply with your practice's privacy policies and local regulations.