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.
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:12/1/2018 11:30:05 AM
The Infant Toddler Tracking Plan is used by local Infant Toddler Early Intervention programs to identify the supports provided to children and families involved in PA’s Early Intervention tracking program.
Age:Infant/Toddler
Language:English
Effective Date:12/1/2022 1:23:08 PM
The Infant Toddler Tracking Plan used by local Infant Toddler Early Intervention programs is used to identify the supports provided to children and families involved in PA’s Early Intervention tracking program.
Age:Infant/Toddler
Language:Haitian Creole
Effective Date:12/1/2018 11:33:59 AM
The annotated version of the Infant Toddler Tracking plan provides guidance to staff completing the plan used identifying the supports provided to children and families involved in PA’s Early Intervention tracking program. It is not intended as an exclusive manner for complying with state and/or federal Early Intervention statutes and regulations.
Age:Infant/Toddler
Language:English
Effective Date:12/1/2018 11:36:24 AM
The Spanish version of the Infant Toddler Tracking plan is used by local Infant Toddler Early Intervention programs to identify the supports provided to children and families involved in PA’s Early Intervention tracking program.
Age:Infant/Toddler
Language:Spanish
Effective Date:12/1/2018 12:00:00 AM
The Infant Toddler Tracking Plan, Arabic version, is used by local Infant Toddler Early Intervention programs to identify the supports provided to children and families involved in PA’s Early Intervention tracking program.
Age:Infant/Toddler
Language:Arabic