What Is It and How Does It Work

Spinal Network’s assistive technology loan closet is an inventory of assistive technology devices available for loan to individuals who have a permanent spinal cord injury or disease. A strategic plan must be in place, including goals set by the clinical team, how the equipment will assist in achieving long term goals and how the equipment will be purchased from the vendor. Spinal Network is not a vendor for any of the inventoried equipment and will not benefit financially from any purchase of said equipment. The loan period will be up to 60 days. If a combination of devices proves to be unsuccessful, a new combination will be trialed restarting the 60 -day trial.

Assistive Technology List of Devices

Assistive Technology Equipment Request

MM slash DD slash YYYY


Please describe the degree of upper extremity function (fingers, hands, arms, shoulders, head)

Devices Required(Required)
If other devices are required, please list with any comments that will help assure a positive assessment.

Please list your specific goals, what do you hope to accomplish with the equipment provided such as access your computer, the internet, control smart home devices.

Case Open with the Following Agencies(Required)

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