Please return to:
Regional Assistive Technology Coordinator
P O Box ……
As
Assistive Technology
Review form
This form is used when reviewing the effectiveness of assistive
technology allocated by the Ministry of Education. We would
appreciate feedback that may include success stories or issues
that have arisen during the initial allocation period.
It is designed for use at an IEP at about 6 months after the
initial allocation of assistive technology, but reviews may be
undertaken at any time and feedback is always welcome.
School to complete
Student name:
________ Assistive technology allocation date:
School name:
School email/contact:
Reviewer name:
Reviewer email/contact:
1. What assistive technology was allocated?
Assistive technology item
Serial #
MoE equipment ID #
Please provide serial numbers and attach a copy of invoice as proof of purchase if not already completed
2. How well is the current assistive technology meeting student needs (tick one box)
Exceeding expectations
Meeting expectations
Below expectations
Not in use
3. How is the assistive technology being used to support learning?
4. Other comments
Signed (Principal): ______________________________________________ Date: __________________________________
Page 1 of 1 Version May 2016
ASSISTIVE TECHNOLOGY – Supporting Students with Special Needs