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Print Form Draft Assistive Technology Referral Form Student Information Student's Name Date of Birth School Grade Completed by Date Referral Question: What task(s) does the student need to do that

How to fill out assistive technology referral form

How to fill out an assistive technology referral form:

1. Begin by carefully reading and understanding the instructions provided on the form. It's important to familiarize yourself with the requirements and guidelines for completing the referral form accurately.
2. Start by providing your personal information. This typically includes your full name, contact details, and any relevant identification numbers.
3. If applicable, enter the name and contact information of the individual or organization making the referral.
4. Provide a detailed description of the individual who requires assistive technology. This may include their name, age, gender, and any specific disabilities or challenges they face.
5. Specify the type(s) of assistive technology needed. This could include devices like hearing aids, screen readers, speech recognition software, or mobility aids.
6. If there is a specific reason for the referral, such as a recent diagnosis or change in the individual's condition, ensure that it is clearly stated on the form.
7. Include any supporting documentation that may be required, such as medical reports, assessment results, or recommendations from healthcare professionals familiar with the individual's needs.
8. Sign and date the referral form to validate the information provided.
9. Review the completed form to ensure that all sections have been filled out accurately and completely. Double-check for any spelling errors or missing information.
10. Submit the form as instructed, whether it's by mail, email, or through an online portal.

Who needs an assistive technology referral form?

1. Individuals with disabilities or special needs who require assistive technology to enhance their abilities and independence often benefit from completing an assistive technology referral form.
2. Medical professionals, educators, or social workers who work closely with individuals with disabilities may also need to complete these forms to initiate the process of obtaining appropriate assistive technology devices or services.
3. Family members or caregivers who support individuals with disabilities can also assist in completing these referral forms to ensure the proper tools are provided to enhance their loved one's quality of life.

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What is assistive technology referral form?

Assistive technology referral form is a document used to request assistive technology devices or services for individuals with disabilities.

Who is required to file assistive technology referral form?

Anyone responsible for the care or education of an individual with a disability may be required to file an assistive technology referral form.

How to fill out assistive technology referral form?

Assistive technology referral forms can usually be filled out online or by hand, providing information about the individual in need of assistive technology and the requested devices or services.

What is the purpose of assistive technology referral form?

The purpose of an assistive technology referral form is to facilitate the provision of appropriate assistive technology devices or services to individuals with disabilities.

What information must be reported on assistive technology referral form?

Information such as the individual's name, contact information, type of disability, requested assistive technology devices or services, and any supporting documentation may need to be reported on the assistive technology referral form.

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