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Run: AAC Device Trial Log

An AAC Device Trial Log template for documenting evaluation context, device and access trials, performance, and the final recommendation. Use it to compare o...

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Evaluation Context

Evaluation Date (required)

Patient Initials (required)

Use initials instead of full name when possible to minimize PII.

Patient Age Group (required)

Evaluation Setting (required)

Referral / Communication Need (required)

Briefly describe the communication need being addressed. Avoid unnecessary clinical detail.

Consent to Document Evaluation Details (required)

Confirm that appropriate consent or authorization has been obtained for documenting evaluation details, including any PII collected.

Yes No N/A

Baseline Communication Profile

Current Communication Methods (required)

Primary Communication Goals (required)

Motor / Access Limitations

Baseline Notes

Summarize relevant baseline communication strengths, barriers, and supports.

Device and Access Trials

Trial Summary (required)

Add one entry for each device or access method trialed.

Device / System Trialed (required)

Access Method (required)

Feature Match (required)

Performance Rating (required)

Trial Observations

Document accuracy, speed, prompting level, fatigue, and any barriers observed during the trial.

Outcome and Recommendation

Preferred AAC System (required)

Recommended Access Method (required)

Recommendation Rationale (required)

Explain how the recommended system and access method match the patient's needs, performance, and feature requirements.

Additional Supports Needed

Clinician Name (required)

Enter the clinician completing the evaluation record.

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Email (required)

Your name (optional)

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