Communication Contract

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My sound(s)/goal:__________________
Communication Contract
I, ___________________________, agree to the terms and conditions of the following contract as negotiated
with _____________________(Speech-Language Pathologist) on the _______ day of _____________ in the year __________.
I would like you to help me use my speech/language skills at home and when in the classroom when _______________
___________________________________________________ (reading outloud, asking/answering questions, speaking all the time).
You can remind me to use my speech skills by using this special signal only we know about:
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________.
A self-rubric and teacher-rubric will be completed a couple times a week to help me remind myself and remind
my teacher that we are working together to help me graduate from speech.
I agree to put forth my best effort to complete the items as listed above.
" I want to graduate 
from speech! "
____________________________________ (student signature)
I agree to provide assistance and advice to my student throughout the term of this contract.
____________________________________ (teacher signature)
I will support and assist my child in meeting the terms of this contract.
____________________________________ (parent/guardian signature)
____________________________________ (parent/guardian signature)
Created by: Brianne Ruhnke MS, CCC-SLP

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