Access - LISC Digital Navigator Intake Form

This form aims to capture your interactions, as digital navigators, with clients. Through these interactions, LISC will measure our impact on digital inclusion.
Basic Information
Digital Navigator's Basic Information



Client's Basic Information



Access 
Devices













Broadband Connectivity










If desired, Digital Navigators can help clients check the quality of wired and mobile internet service available where they are. We recommend the client test internet speed using the TestIt app, developed by Rural LISC and partners.  This app is available in the Apple App Store and on Google Play. 

More info: 
naco.org/resources/testit or 
https://www.lisc.org/rural/our-work/digital-inclusion/test-it/The app will report upload and download speed; please make a note of both.

Submitting and Saving This Survey
PRESS THE SUBMIT BUTTON BELOW THIS BOX TO SUBMIT THIS SURVEY.

Before you submit this survey, you can save the survey as a PDF to store  your client's information.  To save as a PDF on a computer, see the steps below.

Step 1: With the web browser active, click File on the menu bar and choose the Print... option on the drop-down menu.  Alternatively, press Command + P to open the printer window.

Step 2: On the following pop-up, click the down arrow located in the bottom left corner, as shown above.  Select Save as PDF on the resulting drop-down menu.

For instructions on saving as a PDF for specific web browsers and for tablets, go to this link: https://www.digitaltrends.com/computing/how-to-save-a-webpage-as-a-pdf/