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 81
Annotated Individualized Education Program with COVID-19 Guidance. cover image

Annotated Individualized Education Program with COVID-19 Guidance.

Effective Date:8/28/2020 11:29:34 AM
This version of the annotated IEP provides guidance related to the school closures associated with COVID-19
Age:School Age
Language:English
A Family’s Introduction to Early Intervention in Pennsylvania cover image

A Family’s Introduction to Early Intervention in Pennsylvania

Effective Date:7/13/2020 2:00:56 PM
This booklet explains how to request Early Intervention services; eligibility criteria; rights and responsibilities; individualized family service planning for ages birth to three; and individualized education planning for ages three to school age. For copies, please contact connecthelp@tiu11.org.
Age:Infant/Toddler,Preschool
Language:English
INTENT TO REGISTER –First Grade Eligible (Age of Beginners)  cover image

INTENT TO REGISTER –First Grade Eligible (Age of Beginners)

Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. The Preschool Early Intervention program is to provide this form to the parent at the Transition meeting (that is to be held by the end of February) and is to be completed jointly by the preschool and the school district or charter school.
Age:School Age,Preschool
Language:English
NOTICE OF RECOMMENDED EDUCATIONAL PLACEMENT/PRIOR WRITTEN NOTICE (NOREP/PWN) - School Age  cover image

NOTICE OF RECOMMENDED EDUCATIONAL PLACEMENT/PRIOR WRITTEN NOTICE (NOREP/PWN) - School Age

Effective Date:11/16/2014 11:00:00 PM
This NOREP/PWN form provides a format that LEAs may choose to communicate to parents the recommended educational program for their child and other actions taken by the LEA. This revised NOREP/PWN includes additional resources for parents on page 4. The revised form contains the footer “October 2014.”
Age:School Age
Language:English
Special Education State Complaint Resolution Procedures cover image

Special Education State Complaint Resolution Procedures

Effective Date:2/29/2016 11:00:00 PM
This publication outlines the procedures that are followed when complainants allege that the rights of one or more students eligible for services under the IDEA, Chapters 14 or 711 in the State Board Regulations or corresponding federal statutes or regulations have been violated. The IDEA requires the Bureau of Special Education (BSE) to encourage local and less adversarial resolutions to issues. However, federal regulations are clear that resolution activities cannot bar the complaint investigation process. The purpose of these procedures is to: 1. Clearly articulate the process to be followed. 2. Serve as a reference guide and training document. 3. Ensure compliance with federal and state guidelines.
Age:School Age
Language:English
Evaluation Report  cover image

Evaluation Report

Effective Date:7/1/2018 8:41:03 AM
This revised Evaluation Report (July 2018) replaces the July 2008 version and 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.
Age:School Age
Language:English
Reevaluation Report  cover image

Reevaluation Report

Effective Date:7/1/2018 8:41:03 AM
This revised Reevaluation Report (July 2018) replaces the July 2008 version and 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.
Age:School Age
Language:English
AGREEMENT TO WAIVE REEVALUATION - School Age cover image

AGREEMENT TO WAIVE REEVALUATION - School Age

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
Individualized Education Program (IEP) cover image

Individualized Education Program (IEP)

Effective Date:2/1/2020 8:41:03 AM
Revised IEP February 1, 2020 – This revised form (with footer February 1, 2020) provides changes to section IV (the elimination of required video recording and narrative notes for students taking the PASA) per the PENN*LINK issued December 16, 2019.
Age:School Age
Language:English
COMMUNICATION PLAN - School Age  cover image

COMMUNICATION PLAN - School Age

Effective Date:7/1/2008 11:00:00 PM
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