This form gathers intake information that allows the navigator to stay in contact with the client over repeated appointments and determine their reasons for scheduling the appointment. It also provides a means for the navigator to assess basic skills and needs in categories such as account management, adaptability, computer skills, device access, hardware and software knowledge, access to the internet, knowledge for their safety and security, and their smartphone skills.
The navigators were provided with an explanation sheet to help them understand the intent of each question and to standardize answers for data entry. This form and the explanation sheet are attached below. The actual questions in the form are found in rich text on the Data subpage, Client Intake and Assessment Form Questions.
Appointment Report:
The Appointment Report is designed to prompt the navigator to reflect on the appointment, note the desire on the part of the client for new visits on new topics and/or for a device. Appointment reports by navigators are reviewed by the Project Coordinator and maintained as working records for the navigator.
Testimonial Form:
The testimonial form is designed to allow clients who want to be part of a digital equity advocacy project to go on record supporting navigation services and to describe what it meant to them.

This project was made possible in part by the Institute of Museum and Library Services, National Leaders Grants - Libraries award LG-254838-OLS-23, administered by the CT State Library.
Connecticut State Library | 231 Capitol Avenue, Hartford, CT 06106 | 860-757-6500 * Toll-free 866-886-4478
Disclaimers & Permissions | Privacy Policy | State of Connecticut Home Page
The State of Connecticut is an Affirmative Action/Equal Opportunity Employer and strongly encourages the applications of women, minorities, and persons with disabilities.