Equipment Loan Request Form

Equipment Loan Requests should be submitted no earlier than two weeks prior to the start of the semester you are requesting the technology for.
Name * Required
First Last
UFID * Required
GatorLink Email * Required
Semester * Required
Year * Required
What technology will you need to remove your barrier? (Select all that apply) * Required
- Livescribe Echo 2.0
- Dragon
- Revolab xTag Single
- Willam Sound Motiva Personal FM 360 System
- Shoulder Strap Support Rig
- Phonak FM
- Phonak Mic
- Other
Please complete the following form to request a piece of equipment through the DRC’s Equipment Loan program. Submitting this form does not guarantee that you will be loaned the equipment. An Accessibility Specialist will contact you shortly. If approved, you will need to complete the Equipment Loan Agreement.
What barrier does your requested equipment address?
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