Forms

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.

Bureau of Special Education Complaint Form


Access the State Complaint Form on PDE's State Complaints and Dispute Resolution page

State Complaint Forms in other languages are also available on the State Complaints and Dispute Resolution page. 

Complaint Resolution Procedures

If you need more information about the complaint process or if you are unable to print the packet and would like to receive a complaint form by mail, please contact the Special Educaton ConsultLine at 1-800-879-2301, ConsultLine@odr-pa.org or submit an online request.

Results 1-10 of 419
 Early Intervention Session Note – Spanish Version cover image

Early Intervention Session Note – Spanish Version

Effective Date:7/1/2023 1:19:30 PM
The standardized session note form is to be used by all Infant/Toddler Early Intervention programs. The session note reflects the Key Principles of Early Intervention in PA. It documents the provision of services and supports, assures communication with families or caregivers, and provides a mechanism to monitor the progress toward the Individualized Family Service Plan (IFSP) outcomes/goals.
Age:Infant/Toddler
Language:Spanish
 Mitteilung über das Meeting bzgl. Des Übergangs Ihres Kindes zum Schulalter  cover image

Mitteilung über das Meeting bzgl. Des Übergangs Ihres Kindes zum Schulalter

Effective Date:1/1/0001 12:00:00 AM
Notice Of Your Child’s Transition To School Age Meeting Dieses Formular ist gültig ab März 2014. Die Vorschule des Früherfassungsprogramms ist verantwortlich dafür dieses Formular am oder vor dem 1. Februar den Erziehungsberechtigten aller Kinder zu schicken, die sich dem Kindegartenalter oder dem Alter der ersten Klasse nähern.
Age:Preschool,School Age
Language:Polish
 재평가 보고서(RR) - 취학 연령  cover image

재평가 보고서(RR) - 취학 연령

Effective Date:6/30/2008 11:00:00 PM
REEVALUATION REPORT (RR) - School Age 본 양식은 2008년 1월 1일부터 유효하며 개정된 14조 및 711조의 새로운 조항을 반영합니다. 개정된 재평가 보고서("2008년 7월 개정"이라는 바닥글 추가)는 현재의 재평가 보고서를 대체합니다. 해설판 이용 가능
Age:School Age
Language:Korean
ABSICHT ZUR ANMELDUNG - Kind zulässig für die erste Klasse (Anfängeralter)  cover image

ABSICHT ZUR ANMELDUNG - Kind zulässig für die erste Klasse (Anfängeralter)

Effective Date:1/1/0001 12:00:00 AM
INTENT TO REGISTER –First Grade Eligible (Age of Beginners) Dieses Formular ist gültig ab März 2014. Das Früherfassungsprogramm umfasst die Übergabe dieses Formulars dem Erziehungsberechtigten beim Übergangsmeeting (das Ende Februar stattfindet), und das Formular muss von der Vorschule zusammen mit dem Schulbezirk oder der Charterschule ausgefüllt werden.
Age:School Age,Preschool
Language:Polish
ABSICHT ZUR ANMELDUNG - Kind zulässig für die erste Klasse (Anfängeralter)  cover image

ABSICHT ZUR ANMELDUNG - Kind zulässig für die erste Klasse (Anfängeralter)

Effective Date:1/1/0001 12:00:00 AM
INTENT TO REGISTER –First Grade Eligible (Age of Beginners) Dieses Formular ist gültig ab März 2014. Das Früherfassungsprogramm umfasst die Übergabe dieses Formulars dem Erziehungsberechtigten beim Übergangsmeeting (das Ende Februar stattfindet), und das Formular muss von der Vorschule zusammen mit dem Schulbezirk oder der Charterschule ausgefüllt werden.
Age:Preschool,School Age
Language:German
ACCORD POUR RENONCER A LA REEVALUATION - Âge Scolaire cover image

ACCORD POUR RENONCER A LA REEVALUATION - Âge Scolaire

Effective Date:6/30/2008 11:00:00 PM
AGREEMENT TO WAIVE REEVALUATION - School Age Ce formulaire prend effet le 1er juillet 2008. Ce nouveau formulaire permet d'obtenir un accord parental pour renoncer à une réévaluation. Cette demande a déjà été incluse dans le formulaire «Autorisation de réévaluation/Accord de renonciation à la réévaluation». Version annotée disponible.
Age:School Age
Language:French
Act 26 Questions and Answers cover image

Act 26 Questions and Answers

Effective Date:1/1/0001 12:00:00 AM
Act 26 Questions and Answers
Age:
Language:English
ACUERDO PARA RENUNCIAR A LA REVALUACIÓN - Edad escolar cover image

ACUERDO PARA RENUNCIAR A LA REVALUACIÓN - Edad escolar

Effective Date:1/1/0001 12:00:00 AM
AGREEMENT TO WAIVE REEVALUATION - School Age Este formulario entrará en vigor a partir del 1° de julio de 2008. Este nuevo formulario se utiliza para obtener el acuerdo de los padres a fin de descartar la reevaluación. Esta solicitud se incluyó previamente en el formulario "Permiso para reevaluar / Acuerdo para renunciar a la reevaluación". Versión con acotaciones disponible
Age:School Age
Language:Spanish
AGREEMENT TO WAIVE REEVALUATION - School Age cover image

AGREEMENT TO WAIVE REEVALUATION - School Age

Effective Date:6/30/2008 11:00:00 PM
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.
Age:School Age
Language:English
Agreement to Waive Reevaluation (Italian) cover image

Agreement to Waive Reevaluation (Italian)

Effective Date:6/30/2008 11:00:00 PM
CONSENSO ALL’ESONERO DELLA RIVALUTAZIONE – 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.
Age:School Age
Language:Italian