PATINS Lending Library Loan Evaluation
Important - This short evaluation is required for EACH item borrowed from the PATINS Lending Library. When completing an evaluation for an iPad with apps borrowed, please submit an evaluation for each app borrowed.

The information you provide helps us offer better recommendations about equipment for future users and also to justify the time, effort and resources needed to maintain the lending library. Thank you.  

RETURN SHIPPING
Return UPS Shipping Insurance is now at the discretion of the sender.

NOTE: All UPS return labels will be processed within one business day for Loan Evaluations received.

Sign in to Google to save your progress. Learn more
 School Corporation & School/Agency Name *
Item/Device Evaluation:  Please fill out an evaluation for EACH item borrowed. *
Item/Device Name
Please check ALL that apply *
Required
Student Age(s) *
Primary Disability(s) of Student(s). *
Required
Did you borrow this item with the intent to improve access to literacy activities? *
Was there an improvement in Literacy access as a result of borrowing this item? *
None
Remarkable
Was Borrowed Item appropriate for the student? *
Did the student's academic achievement improve as a result of using Borrowed Item? *
Did the student's behavior improve as a result of using Borrowed Item? *
Did the student's participation in general ed. increase as a result of using Borrowed Item? *
If there was improvement, please provide information regarding success. *
If there was not, do you have any insights as to why it didn't?
Please Check All That Apply: *
Required
Tell us about the service PATINS Lending Library provided. *
Please rate your satisfaction with the service that the PATINS Site provided.
Please share any additional comments:
Would you or your staff/colleagues like any FREE training or consultation that PATINS can provide for you?
If so, please provide specific training needs and contact information.  We will be happy to assist you.
We sometimes use borrower's comments or feedback for our website to provide personal experiences of devices/equipment use and our services for other educators. May we use yours? *
Do you have another item/device that you need to evaluate? *
First and Last Name *
Your Email: *
patinsproject.org logo
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy