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: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
Effective Date:11/16/2022 12:00:00 AM
Infant Toddler Early Intervention Evaluation Report, Chinese 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:
Effective Date:12/1/2018 12:00:00 AM
This abbreviated Infant Toddler Early Intervention Evaluation Report, French 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:French
Effective Date:3/1/2012 12:00:00 AM
Spanish version of the letter of invitation for transition to the Preschool EI Program or to other community services. Invitation letters must be sent to the family, Preschool EI Program and other participants no later than 30 days before the scheduled transition meeting date, unless the parties all agree to meet within shorter timelines.
Age:Infant/Toddler,Preschool
Language:Spanish
Effective Date:12/1/2023 12:00:00 AM
This form translated into Arabic summarizes recommendations for a child’s preschool educational program and other actions proposed by the Preschool Early Intervention program. The form also includes state and local resources that provide additional information on the special education process.
Age:Preschool
Language:Arabic
Effective Date:11/15/2019 12:00:00 AM
The Arabic version of the Early Intervention Communication Plan has detailed discussion points that families with children who are deaf or hard of hearing and IFSP or IEP team members should consider during plan development. Information in the plan addresses language and communication needs; communication options, opportunities for direct communication; and progress, assistive technology, devices and services. It also provides a glossary of terms for use.
Age:Infant/Toddler,Preschool
Language:Arabic
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
Effective Date:1/1/0001 12:00:00 AM
Act 26 Questions and Answers
Age:
Language:English
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
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