Digital Navigator Forms

Framework provided by National Digital Inclusion Alliance

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Use the following documents/forms to support working with clients and collect data.

If your organization already has a version of these documents, you may use those.

Forms in English

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Intake Form: Use this form to collect general information about your community member鈥檚 technology needs.
(.pdf, 342.12 KB)
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Skills Assessment: The purpose of this form is to get a general idea of your community member鈥檚 comfort with technology.
(.pdf, 332.23 KB)
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Session Summary Form (formerly 鈥淓xit Survey鈥) To be completed after speaking with a community member to record details of the interaction.
(.pdf, 327.42 KB)
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Follow-up Survey To be completed with a community member at regular intervals as a matter of checking in, and also to record any growth in their learning.
(.pdf, 324.14 KB)

Forms in Spanish

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Intake Form SPANISH
(.pdf, 353.38 KB)
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Skills Assessment SPANISH
(.pdf, 347.75 KB)
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Session Summary Form (formerly 鈥淓xit Survey鈥) SPANISH
(.pdf, 314.31 KB)

Follow Up Form in Spanish: Coming Soon

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