AT Device Request
This is to request an assistive technology device, without having an AT member come out and visit. *** Please note that the device will be put on the van within a week or so of the request. (Depending on Tiffanie's schedule, so please plan accordingly.)
Name of Person Requesting *
Your answer
Name of office or building to send the device *
Your answer
Name of student and student's building and district with which the device will be used. *
Your answer
Name of device requested *
Your answer
What process did you use to determine this need? *
Provide the data that supports the use of trialing this device. *
Your answer
Submit
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