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 and State Complaint Resolution Procedures on PDE’s Special Education Dispute Resolution page. This webpage also contains the State Complaint Form translated into other languages.
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.
IEP in Braille
Download the Nemeth format ⏷
Download the UEB format ⏷
Effective Date:11/16/2022 12:00:00 AM
Infant Toddler Early Intervention Evaluation Report, Russian version, documents information on a child and family, including strengths and needs, provides eligibility determinations, and provides recommendations for supports that can assist the young child to develop, learn and grow.
Age:Infant/Toddler
Language:Russian
Effective Date:12/1/2018 12:00:00 AM
Early Intervention Evaluation Report in Spanish for use as of December 2018. The Evaluation Report documents information on a child and family, including strengths and needs, provides eligibility determinations, and provides recommendations for supports that can assist the young child to develop, learn and grow.
Age:Infant/Toddler
Language:Spanish
Effective Date:12/1/2018 9:53:50 AM
This abbreviated Infant Toddler Early Intervention Evaluation Report provides local Infant Toddler Early Intervention programs the ability to document the minimum information necessary to determine eligibility for children ineligible for Early Intervention Services, but eligible for tracking services.
Age:Infant/Toddler
Language:English
Effective Date:12/1/2018 12:00:00 AM
This abbreviated Infant Toddler Early Intervention Evaluation Report, Arabic version, provides local Infant Toddler Early Intervention programs the ability to document the minimum information necessary to determine eligibility for children ineligible for Early Intervention Services, but eligible for tracking services.
Age:Infant/Toddler
Language:Arabic
Effective Date:12/1/2018 12:00:00 AM
This abbreviated Infant Toddler Early Intervention Evaluation Report, Chinese version, provides local Infant Toddler Early Intervention programs the ability to document the minimum information necessary to determine eligibility for children ineligible for Early Intervention Services, but eligible for tracking services.
Age:Infant/Toddler
Language:Chinese
Effective Date:12/1/2018 12:00:00 AM
This abbreviated Infant Toddler Early Intervention Evaluation Report, Nepali version, provides local Infant Toddler Early Intervention programs the ability to document the minimum information necessary to determine eligibility for children ineligible for Early Intervention Services, but eligible for tracking services.
Age:Infant/Toddler
Language:Nepali
Effective Date:12/1/2018 12:00:00 AM
This abbreviated Infant Toddler Early Intervention Evaluation Report, Portuguese version, provides local Infant Toddler Early Intervention programs the ability to document the minimum information necessary to determine eligibility for children ineligible for Early Intervention Services, but eligible for tracking services.
Age:Infant/Toddler
Language:Portuguese
Effective Date:12/1/2018 12:00:00 AM
This abbreviated Infant Toddler Early Intervention Evaluation Report, Russian version, provides local Infant Toddler Early Intervention programs the ability to document the minimum information necessary to determine eligibility for children ineligible for Early Intervention Services, but eligible for tracking services.
Age:Infant/Toddler
Language:Russian
Effective Date:12/1/2018 9:56:43 AM
This is the Spanish version of the abbreviated Infant Toddler Early Intervention Evaluation Report that provides local Infant Toddler Early Intervention programs the ability to document the minimum information necessary to determine eligibility for children ineligible for Early Intervention Services, but eligible for tracking services.
Age:Infant/Toddler
Language:Spanish
Effective Date:4/1/2025 12:00:00 AM
The Infant Toddler Early Intervention Procedural Safeguards form includes a full explanation of the rights available to parents of an infant or toddler who has been referred to or is receiving Early Intervention Services. This form outlines the important topics such as parental consent, access to records, confidentiality, and dispute resolution options.
Age:Infant/Toddler
Language:Arabic