This request form is provided by Accessibility Clinic Inc., a 501(c)(3) nonprofit organization. Evaluation fees help support the clinic's broader nonprofit mission; see Funding, Payment & Eligibility for details.
If you would like to ask a question or request an assistive technology evaluation, we would be glad to hear from you. To help us respond, please share the information below by email to info@accessibilityclinic.org. Please do not include sensitive medical details in your message; we only need enough information to make initial contact.
Information that helps us respond:
Name
Phone (only if you would like a call)
Your role: parent or family member; school or district representative; adult or self-referral; professional or provider; or other
General setting: school; home; workplace; community; or other
A brief description of your primary concern or reason for requesting an evaluation
General service location (city/region or ZIP)
Preferred contact method
Privacy note: We ask only for information reasonably necessary to make initial contact. Please avoid sending detailed medical, diagnostic, or other sensitive information through general email or website messages. For details on how information is handled, see our Privacy Policy.
Open the Evaluation Request Form
For Professionals and Referral Sources
Teachers, therapists, case managers, and other professionals sometimes recognize that a student, client, or family member may benefit from learning more about assistive technology, AAC, or educational AT evaluation options. The pages on this site describing what an evaluation involves, who may benefit, and what to expect are written so they can be shared with the people you support.
If you believe additional information or a formal evaluation may be helpful, you can point the individual or family to this site, or use Request an Evaluation to begin the process. As with any request, the evaluation remains an individualized process; sharing information or submitting a request does not by itself determine the outcome of that process or replace the person's existing educational or care team.
For Schools and Districts
School and district staff, including teachers, related-service providers, and administrators, sometimes want to learn more about assistive technology, AAC, or educational AT evaluation options, whether for a single student or as part of broader planning. The pages on this site describing evaluation types, funding pathways, and Independent Educational Evaluations are written to be useful for school-based readers as well as families.
Schools and districts may arrange an evaluation through their own processes, and purchase orders may be accepted for school systems. For independent educational evaluations that involve travel, schools and districts may also request a custom quote. As with any request, next steps depend on the specific situation, and submitting an inquiry does not by itself determine eligibility, IEP decisions, or a district's obligations, which remain part of the student's existing educational team process.