Communication Assistive Technology Level One Assessment Report

Please complete the following assessment template. TalkLink can provide assistance to therapists who have or are seeking Communication Assistive Technology (CAT) Level 1 credentialing. Once complete send to your CAT supervisor for peer review and sign off.

Assessor Details:

Name:

AEA No:

Email:

Phone:

Persons Details:

Name:

Address:

Phone Number:

Date of Birth:

NHI number:

Gender:

Ethnicity:

Community Service Card holder:

Resides in (own home, residential care etc.):

Diagnosis:

Reason for Assessment:

Background (include relevant disability, functional limitations, current social situation and existing environment)

Identified Needs (Include details of how needs are currently being met)

Specific Outcomes to Be Met (SMART assessment goals where possible)

Equipment options considered (equipment options that have been considered; important features and functions; why these alternatives do not meet the essential needs)

Possible Options:
Important Features and Functions:

Assessment Outcomes (include clear trial goals and outcomes, include vocabulary configuration where appropriate)

Recommendations and Rationale (list total package)

Equipment setup, training and support (include training goals, who to be trained and what will be covered)

It is recommended that the equipment be set up at TalkLink and then delivered to the assessor. Training as per the plan will follow.

Training Goals - SMART	Strategies and supports

Quote or Link to equipment

Assessor:

Peer reviewed by/ Supervising CAT Therapist: