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United States Department of Agriculture

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USDA/CAP Partnership AT and Training Request Form


If you are unsure of your technology and training needs, please Start Your TARGET Experience to request an AT Needs Assessment.

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AT Request Information

Give us a description of his/her specific impairment(s) or functional limitations. Is there a medical diagnosis from a doctor? Is this a new condition or something that he/she been dealing with long-term?

Has he/she used assistive technology before? If so, what?

Provide a description of normal tasks that the Employee needs to perform and complete at work that are hindered by his/her limitations. You may want to describe the current work environment, interactions with co-workers and/or supervisors or any other details that you feel could be helpful.