This site includes forms designed by the Pennsylvania Department of Education to ensure that students with disabilities receive a free, appropriate, public education. Forms are available for the Infant-Toddler/Early Intervention, Preschool/Early Intervention, and School-age programs, and include both annotated and non-annotated versions. Forms are available as Word and pdf documents.Currently viewing results 1-10 of 20
This form is effective beginning July 1, 2008. This new form is used to obtain parental agreement to waiving a reevaluation. This request previously was included in the “Permission to Reevaluate/Agreement to Waive Reevaluation” form.
The Complaint Form and procedures are to be utilized to file a complaint with the Bureau of Special Education. Please feel free to make copies of this form, use additional paper, or call the ConsultLine at 1-800-879-2301 or the Bureau of Special Education (BSE) at 717-783-6913 for additional copies.
This form is used to submit a formal complaint to the PA Department of Education, Bureau of Special Education (BSE) – Division of Compliance. This form replaces the Consumer Request Intake form which had been used prior to October 13, 2006. The first link will provide access to the actual complaint form, which can be downloaded. It must be properly completed and signed before sending it to the BSE. The second link provides important information about the complaint process. You may find this information to be useful before completing the complaint form. If you need more information about the complaint process or if you are unable to print the form and would like to receive a complaint form by mail, please contact the Special Education ConsultLine at 1-800-879-2301 (within the state of Pennsylvania) or 717-901-2146.
The Communication Plan must be included in the IEP of any student who is deaf or hard of hearing. The Communication Plan form was revised December 2010. At that time additions were made in Sections I and III of the plan to include communication needs and assistive technology devices and services for students who are deafblind. The revised plan has a footer reading December 2010.
This form is effective beginning July 1, 2008 and reflects new provisions of revised Chapters 14 and 711. This new Evaluation Report (with a footer indicating “July 2008 Revisions”) replaces the current ER.
Revised IEP April 2014 – This revised form (with footer April 2014) clarifies state directives related to state assessment administration requirements and are reflected in Section IV, PARTICIPATION IN STATE AND LOCAL ASSESSMENTS, of the IEP. The changes to the IEP clarify the requirement of the Pennsylvania Keystone Exams to serve as the 11th grade Pennsylvania accountability measure for all students with IEPs, except those who are eligible to participate in the alternate assessment.
This form is available in Word and PDF formats.
This form is effective beginning March 2014. The Preschool Early Intervention program is to provide this form to the parent at the Transition meeting (that is to be held by the end of February) and is to be completed jointly by the preschool and the school district or charter school.
Revised May 2015 – This new Invitation to Participate in the IEP Team Meeting or Other Meeting (with footer indicating “May 2015 Revisions”) replaces the current Invitation. This revised form adds supplementary purposes for an IEP team meeting, removes the requirement to use two separate Invitation to Participate in the IEP Team Meeting or Other Meeting forms for transition planning/services, and supplements the explanations for transition planning and services, including a statement that the local education agency (LEA) will invite the student, if age 14 or above. This form is effective beginning June 30, 2015.
This Penn*LINK announces the release of a supplement to the IEP Form for use beginning February 1, 2008. The IEP Supplement is posted at www. pattan.net under Regulations and Forms – Chapter 14 – School Age Forms www.pattan.net/files/Memos/Pennlink010808b.pdf and www.pattan.net/files/Memos/Pennlink010808b.doc
This NOREP/PWN form provides a format that LEAs may choose to communicate to parents the recommended educational program for their child and other actions taken by the LEA. This revised NOREP/PWN includes additional resources for parents on page 4. The revised form contains the footer “October 2014.”