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School-Age Forms

School-age forms are designed to ensure that students with disabilities receive a free, appropriate, public education. The forms include all items required under state and federal regulations.

School districts have many options for obtaining these forms. Click on the document links below to view and download the forms needed.

English, Non-Annotated Forms

Annotated Forms

Foreign Language Forms

English, Non-Annotated Forms:

Displaying Records 1 through 10 of 18 records.

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PROCEDURAL SAFEGUARDS NOTICE - School Age
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 337KB) View Resource Online (Word document format 414KB)
This revised form reflects provisions regarding new supplemental regulations to 34 CFR Part 300, effective December 31, 2008, regarding parental revocation of special education and related services. This revised Procedural Safeguards Notice includes information relating to the parents' action for the revocation of special education and related services. This form is effective beginning December 31, 2008 (with a footer indicating "December 31, 2008") and replaces the current Procedural Safeguards Notice.

REEVALUATION REPORT (RR) - School Age
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 95KB) View Resource Online (Word document format 224KB)
This form is effective beginning July 1, 2008 and reflects new provisions of revised Chapters 14 and 711. This new Reevaluation Report (with a footer indicating "July 2008 Revisions") replaces the current Reevaluation Report.

SUMMARY OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE - School Age
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 30KB) View Resource Online (Word document format 62KB)
This form is effective beginning July 1, 2008. This revised Summary of Academic Achievement and Functional Performance (with a footer indicating "July 2008 Revisions") replaces the current Summary of Student Performance.

SUMMARY OF CHANGES TO SPECIAL EDUCATION FORMS
Material Description:
Material Type:	Forms & FormatsTraining Materials
Training Date:	6/9/2008
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 54KB)
This document lists changes that have been made to each of the special education forms. The forms are effective beginning July 1, 2008.

AGREEMENT TO WAIVE REEVALUATION - School Age
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 50KB) View Resource Online (Word document format 27KB)
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.

Bureau of Special Education Complaint Form and Information packet
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Parents Chapter 14 Office for Dispute Resolution (ODR)
File Attachment(s):	View Resource Online (Pdf format 69KB)
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 717-541-4960 ext. 3332.

COMMUNICATION PLAN - School Age
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 56KB) View Resource Online (Word document format 122KB)
This form is effective beginning July 1, 2008. This communication plan must be included in the IEP of any student who is deaf or hard of hearing.

EVALUATION REPORT (ER) - School Age
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 671KB) View Resource Online (Word document format 138KB)
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.

INDIVIDUALIZED EDUCATION PROGRAM (IEP) - School Age
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 148KB) View Resource Online (Word document format 215KB)
This form is effective beginning July 1, 2008 and reflects new provisions of revised Chapters 14 and 711. This new IEP (with a footer indicating "July 2008 Revisions") replaces the current IEP. The Educational Placement section of this IEP contains the questions the IEP team must review and discuss regarding the participation of students with disabilities with students without disabilities. Please refer to PennLink dated January 8, 2008 for additional information.

INVITATION TO PARTICIPATE IN THE IEP TEAM MEETING OR OTHER MEETING - School Age
Material Description:
Material Type:	Forms & Formats
Interest Area(s):	Chapter 14
File Attachment(s):	View Resource Online (Pdf format 41KB) View Resource Online (Word document format 82KB)
This form is effective beginning July 1, 2008 and reflects new provisions of revised Chapters 14 and 711. This new Invitation (with a footer indicating "July 2008 Revisions") replaces the current Invitation. This Invitation no longer contains the request for parental consent to excuse members of the IEP team from attending the IEP team meeting. This request now is made with a separate form, "Parental Consent to Excuse Members from Attending the IEP Team Meeting."