Skip to Main Content. Access key M.
Skip to Main Navigation. Access key N.

UT Dallas

Foreign Accent Syndrome (FAS) Support

Family Networking

Networking Request

If you would like to be put into contact with other individuals who are affected by FAS, fill out the following form and FAX to our office at 214/905-3006. Thank you.

Your name:

Phone:

Email address:

Please indicate if you are interested in talking with other families about the following issues by circling the topic:

  • Social issues
  • Clinical Services
  • Conversion Disorder
  • Psychological problems related to speech disorder
  • Other

What do you hope to gain from networking with other families?

Was there an incident leading to your FAS (e.g.: stroke, accident, etc.)?

Signature

Date

By signing this document you are giving your permission to share your email address with other families dealing with FAS.