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:2/1/2014 12:00:00 AM
This form must be issued by the Local Education Agency to obtain written consent to conduct an initial evaluation.
Age:Preschool
Language:Haitian Creole
Effective Date:2/1/2014 12:00:00 AM
This form must be issued by the Local Education Agency to obtain written consent to conduct an initial evaluation.
Age:Preschool
Language:Hebrew
Effective Date:2/1/2014 12:00:00 AM
This form must be issued by the Local Education Agency to obtain written consent to conduct an initial evaluation.
Age:Preschool
Language:Japanese
Effective Date:2/1/2014 12:00:00 AM
This form must be issued by the Local Education Agency to obtain written consent to conduct an initial evaluation.
Age:Preschool
Language:Malayalam
Effective Date:2/1/2014 12:00:00 AM
This form must be issued by the Local Education Agency to obtain written consent to conduct an initial evaluation.
Age:Preschool
Language:Swahili
Effective Date:10/1/2016 12:00:00 AM
This form is effective beginning October 2016. This form must be issued by the Local Education Agency to obtain written consent to conduct a reevaluation.
Age:Preschool
Language:English
Effective Date:10/1/2016 12:00:00 AM
This Arabic version of the form should be issued by the Preschool Early Intervention programs to obtain written consent to conduct a reevaluation.
Age:Preschool
Language:Arabic
Effective Date:10/1/2016 12:00:00 AM
This Chinese version of the form should be issued by the Preschool Early Intervention programs to obtain written consent to conduct a reevaluation.
Age:Preschool
Language:Chinese
Effective Date:10/1/2016 12:00:00 AM
This Nepali version of the form should be issued by the Preschool Early Intervention programs to obtain written consent to conduct a reevaluation.
Age:Preschool
Language:Nepali
Effective Date:10/1/2016 2:53:37 PM
This Portuguese version of the form should be issued by the Preschool Early Intervention programs to obtain written consent to conduct a reevaluation.
Age:Preschool
Language:Portuguese