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 76
 Annotated-Evaluation Report cover image

Annotated-Evaluation Report

Effective Date:7/1/2018 8:41:03 AM
This revised Evaluation Report (Annotated) includes a change in terminology that replaces the term “mental retardation” with the term “intellectual disability.” This change also aligns the Commonwealth’s special education regulations in Chapters 14 and 711 to the Individuals with Disabilities Education Act (IDEA) regulatory revisions resulting from Rosa’s Law. The change in terminology does not affect the meaning or the eligibility determination associated with the term. (July 2018)
Age:School Age Annotated
Language:English
Act 26 Questions and Answers cover image

Act 26 Questions and Answers

Effective Date:
Act 26 Questions and Answers
Age:
Language:English
AGREEMENT TO WAIVE REEVALUATION - Preschool Early Intervention cover image

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 cover image

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 cover image

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 cover image

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  cover image

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 cover image

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 cover image

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 cover image

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