Image of BrailleWriters and BookPorts on a classroom desk

Before submitting your Assistive Technology Referral, please review the following

  1. An Assistive Technology Evaluation Referral is required when requesting specialized equipment to assist a student in accessing school curriculum to meet his or her individual educational needs and achieve academic goals.

  2. Make sure that all supporting documents (Eye Reports, Functional Vision Assessments, etc.) are obtained and they should be separately faxed into SESIS as “Documents Related to IEP” per EVS instructions. Once you have confirmed the supporting documents have shown up in SESIS, don’t forget to finalize that “Documents Related to IEP.” NOTE: If you have already faxed in an eye report or FVA for the student during the current school year, you do not need to re-fax it into SESIS.

    If you have any questions about completing the Vision AT Referral Form, please contact the EVS Technology Liaison.

Instructions for Requesting an EVS
Assistive Technology Evaluation in SESIS
(Updated October, 2020)

Prior to starting the SESIS process, the EVS teacher should download the EVS Assistive Technology Referral Form from the EVS website and complete it, making sure to have all service providers fill out their sections. Also make sure the student has a current Functional Vision Assessment and Eye Report.

EVS Technology Evaluation
Procedures and Responsibilities
(Revised October, 2020)

Instructions for referring a student for a Vision Assistive Technology Evaluation have been updated to fall in line with District 75 procedures. You can download a copy of the instructions from this link:

Vision Assistive Technology Evaluation
including charter school students

Vision Assistive Technology Evaluation
REFERRAL PROCEDURE for students attending a non-DOE school

The DOE has created a step-by-step workflow guide that goes through the procedures to follow in SESIS that the SBST/CSE need to follow when creating a referral for a D75 Vision Assistive Technology Evaluation. Steps 1-10 are completed prior to the evaluation. Step 11 comes after the Vision Assistive Technology Evaluation has been completed and the report has been uploaded to SESIS.

AT Evaluation SESIS Workflow

Step 9 of the workflow concerns uploading parental consent for the Vision Assistive Technology Evaluation. If the consent form cannot be faxed into SESIS, the SBST/CSE must use the workaround at the bottom of page 3 of the Fax/Scan Guidance Remote Blended Learning instructions, in the section labelled “Reevaluation: Consent for Additional Assessments (Assessments Needed)”. The referral cannot be processed and assigned if consent or outreach is not registered on the Assessment Planning document.

It is still necessary to fill out the EVS Assistive Technology Evaluation Referral form in addition to the referral document in SESIS. The form has been updated to reduce duplicate information that is already available in SESIS. It has also been converted to an MS Word file that can be filled out on the computer rather than by hand. Remember to fax the referral form in as an attachment to the SESIS Assistive Technology Evaluation Referral (D75) document. You can download the referral form here:

District 75 Vision Assistive Technology Evaluation Referral Form

For questions about the Vision AT Referral process, contact the EVS Technology Liaison, Vincent Pedulla,

NOTE: Referrals submitted after May 1 will likely be rejected and will need to be resubmitted the following school year.

Guidelines for preparing for
the Assistive Technology Evaluation

  1. As the vision teacher you are an important member of the team during the evaluation process. Plan to organize your schedule so you can participate in the evaluation process.

  2. Promptly notify David Cohen - (917) 256-4238, the assigned evaluator(s) and other appropriate staff members if the student is absent or is expected to be absent on the day of the evaluation.

  3. Make sure that staff that will be asked for input will be in attendance on the day of the evaluation. Absence of key people on the day of the evaluation can result in extended delays in preparing the final report and ordering equipment if appropriate.

  4. Make sure the parent is notified that the evaluation has been requested and invite the parent to participate once the evaluation is scheduled.

  5. Designate a location for the evaluation that provides adequate computer access. (If a password is required to log in, arrange for the presence of an authorized staff member to perform this task.)

  6. Make sure all tools regularly used by the student are available: i.e. Braillewriter, large printbooks, magnifiers, etc.

  7. Student must bring eyeglasses and/or other optical aids or tools to the evaluation.

  8. If the student is provided with equipment that will travel home as a result of the Assistive Technology Evaluation, download and fill out the IEP Mandated Equipment Off-Site Form, have the parent sign it, then fax it into SESIS as a “Document Related to IEP.”

Click here to download the
District 75 Vision Assistive Technology Evaluation Referral Form

Click here to download the
IEP Mandated Equipment Off-Site Form

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