FREE Independent Living Assistive Technology Assessment - Broadened Horizons Direct

FREE Independent Living Assistive Technology Assessment

Broadened Horizons
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A New Service from Broadened Horizons: For Individuals, AT Professionals, Schools, parents and others looking for the latest information on Assistive Technology solutions, Broadened Horizons, Inc. is here to help. Assessing an individual's assistive technology needs makes it far more likely to identify AT devices and services which will improve their functional capabilities.

A poor match between technology and user more often than not leads to abandonment of the technology, and thus loss of the desired outcome. Whether the solutions are available through Broadened Horizons, or any other provider of Asssistive Technology, we offer thorough advice and referrals for the best result.

Organization Name: Title: First name: Last name:
Email: Phone:

Street: City: State: Zip/Postal Code: Country:

How Did You Hear about Us?:


Tell Us about Yourself: Your Abilities & Disability, Goals & Objectives

Disability: Disability Description: Date of Injury: Ability Speak Clearly: Limited Speech: Abilities Description:


Your Wheelchair

Wheelchair Type: Wheelchair Brand: Wheelchair Year: Wheelchair Model: Top 3 Goals or Objectives: Additional Comments:

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