AT Service / Equipment Request Form

 
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  Items denoted with a red asterisk * are required.
   
  Eastport South Manor Central School District Augmentative, Alternative and Assistive Communication and Technology Service Request Form
***Please Note that this is ONLY to be used for AT Evaluation/ Service/Consult***.
For any Technical/IT service, please fill out a Q-Centre ticket @ https://qcweb.esboces.org/esmonline/Login
   
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  EQUIPMENT LOANS: ESM maintains an inventory of assistive technology devices, hardware and software that is available for loan to students or teachers who have been screened and deemed appropriate candidates for additional support.
   
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  EQUIPMENT - REPAIR / REPLACEMENT: Requesting on-site technical assistance to address technical difficulties with assistive technology devices, hardware, and software.
   
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  Purchase Requisition form is located on the Assistive Technology page.
CLASSROOM CONSULTATION / TRAINING: Follow-up consultation and/or training is requested to consult with the special education team to help monitor the assistive technology programs and needs of the classroom and/or individual students.
   
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