Assistive Technology Student Consultation Application

IDAHO School Personnel: Use THIS FORM to request an AT consultation for a specific student.

Please complete the application in one sitting to avoid losing your work! Use Firefox or Chrome browser to complete the form.

Student Information

Parent Information


Applicant Information

Person Completing the Application

School Contact Information

School Address


IEP Team Members

Q19. Please fill in all information for each IEP Team Member

Additional Student Information

Medical Considerations

Assistive Technology Currently Used

Complete all summaries that apply to your student