Family Technology Access Survey

Assesses home internet and device access so the teacher can plan digital assignments equitably.

form exemplar family-communication technology survey equity

Family Technology Access Survey

JaxForm

Family Technology Access Survey

Dear families, this short survey helps us understand your child’s access to technology and the internet at home. Your responses will help us plan digital assignments fairly and ensure all students have the resources they need to succeed.
Student’s Name*
First
Last
Does your student have reliable internet access at home?*
  • Yes, always
  • Sometimes
  • No, rarely or never
Which of these devices does your student have access to at home?*
  • Laptop computer
  • Desktop computer
  • Tablet (e.g., iPad, Fire tablet)
  • Smartphone
  • Other
Please select all that apply.
Does your student typically share their primary learning device with other family members?*
  • Yes
  • No
Do you have any concerns or questions about your student completing digital assignments at home?
e.g., limited screen time, technical difficulties, lack of quiet space, etc.

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