Special Education Assistive Technology Recommendation Form

AT Recommendation Form

Assistive Technology Consideration & Implementation Plan

Recommended AT Plan

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Student Snapshot

Name: --

Grade: --

Primary Area: --

Evaluator: --

Category Distribution

Student Information

Student Name

Grade Level

Disability Category (IEP)

Primary Area of Need

Current Challenges & Functional Goals

AT Tool Catalog

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Administrative Details

Evaluator / Case Manager

School / District

Meeting Date

Currency Symbol