Accessible Instructional Materials Library Forms

It is suggested that all forms be copied for your files prior to submitting them to the AIM Library for your records in case of later verification.

Assurance Form

AIM Library student registration requires the assurance that appropriate assessments, when applicable, current medical records, and a written education plan are on file where the student attends school. The actual assessments, reports and plans are not to be submitted to the Accessible Instructional Materials Library but need to be on file at the school district.

Original, wet signature, Assurances Forms are required every school year for every student and need to be mailed to the AIM Library:

Massachusetts Accessible Instructional Materials Library
3 Randolph Street Canton, MA 02021
Download Assurances Form

Download Assurances Definitions

Download Reporting Codes

Medical Addendum: Optional

Our optional Medical Addendum may be used when an eye report or medical report has no acuities/field measurements. This form can be sent to the doctor’s office for further clarification. For students who may function at the definition of blindness (FDB), when visual performance is reduced by a brain injury, dysfunction, neurological, cortical, or cerebral visual impairment, and need accessible educational materials and supports to access the school curriculum.
Download Medical Addendum

Material Request Form

To be completed by the TVI to ensure that the proper items are being provided for the student’s needs. The TVI is responsible for the proper care & return of these materials.
Download Material Request Form

Teacher Registration Form

Each TVI needs to submit at the time of the Federal Quota Census so the AIM Library is sure to have your current contact information.
Download Teacher Registration Form

Parental Consent to Release Information Form

To be signed by parent or guardian to allow the AIM Library to exchange pertinent information with the Massachusetts Commission for the Blind, American Printing House for the Blind, and the Massachusetts Department of Elementary and Secondary Education. It is recommended that you write in the LEA address for the form to be returned so they can make a copy prior to mailing to the AIM Library.
Download Parental Consent

Print Copy Identification Form

Please fill out and place inside each original textbook submitted to the AIM Library to ensure the return of the textbook to the proper source/student.
Download Print Form

Return Slip Form

To be submitted in boxes with braille, large print and accessible materials being returned to the AIM Library.
Download Return Slip

Free Matter for the Blind Ship to AIM Library Sheet

These may be used to ship materials to the AIM Library. The U.S. Post Office Regulations list the following items as acceptable for this shipping method: Braille embossed materials, print materials 14 point or larger and Tangible accessible instructional materials. All other correspondence (AIM library forms, letters, regular print textbooks, novels and empty shipping containers) must bear the full applicable postage.
Download Print Form

Braille Transcription Syllabus Form

Used for all books in need of transcription, prioritizing the use of chapters in the order in which they will be used. No textbook will be considered for transcription without a Braille Transcription Syllabus. The TVI will be notified in the instance that a Braille Transcription Syllabus is required.
Download Braille Transcription Syllabus