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.

Results: 1 - 10 of 75

Act 26 Questions and Answers

Effective Date:
Act 26 Questions and Answers
Age:
Language:English

AGREEMENT TO WAIVE REEVALUATION - Preschool Early Intervention

Effective Date:
This form is effective beginning March 2014. This form is used to obtain parental agreement to waive a reevaluation.
Age:Preschool
Language:English

AGREEMENT TO WAIVE REEVALUATION - School Age

Effective Date:7/1/2008 4:00:00 AM
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 (Annotated) - Preschool Early Intervention

Effective Date:
This annotated document describes the contents of the Agreement to Waive Reevaluation form. This annotated form offers assistance and guidance to parents and early intervention providers. It is not intended as an exclusive manner for complying with state and/or federal special education statutes and regulations.
Age:Preschool
Language:English

Agreement to Waive Reevaluation (Annotated) - School Age

Effective Date:10/9/2008 4:00:00 AM
This annotated document describes the contents of the Agreement to Waive Reevaluation form, which is used by the LEA to obtain agreement from the parent to waive a child's reevaluation.
Age:School Age
Language:English

Annotated Guidance for Writing Session Notes

Effective Date:
This document provides guidance for writing the standardized session note form that is to be used by all Infant/Toddler Early Intervention programs. Updated March 2013.
Age:Infant/Toddler
Language:English

Authorization to Release Information for Children in Early Intervention

Effective Date:6/9/2015 4:00:00 AM
A standard release form that will allow Early Intervention and other programs supporting a child and family to exchange information.
Age:Infant/Toddler, Preschool
Language:English

Authorization to Release Information for Infants/Toddlers with Hearing Concerns

Effective Date:
A standard release form that will allow Early Intervention and the Department of Health to exchange information with a family of a child who is deaf or hard of hearing.
Age:Infant/Toddler
Language:English

Bureau of Special Education Complaint Information Packet and Form

Effective Date:3/1/2016 5:00:00 AM
This form is used to submit a formal complaint to the PA Department of Education, Bureau of Special Education (BSE) - Division of Compliance. 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 717-901-2146.
Age:School Age
Language:English

COMMUNICATION PLAN - School Age

Effective Date:7/2/2008 4:00:00 AM
The Communication Plan must be included in the IEP of any student who is deaf or hard of hearing. The Communication Plan form was revised December 2010. At that time additions were made in Sections I and III of the plan to include communication needs and assistive technology devices and services for students who are deafblind. The revised plan has a footer reading December 2010. Annotated version available
Age:School Age
Language:English