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:
Spanish version of the Intent to Register for Kindergarten Age children - 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:Preschool
Language:Spanish
Effective Date:
The Early Intervention Communication Plan for use as of November 2019. The 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:English
Effective Date:
Vietnamese Version of the Infant/Toddler Early Intervention Evaluation Report.
Age:Infant/Toddler
Language:Vietnamese
Effective Date:
AVISO DE OPCIONES PARA LA TRANSICION DE SU HIJO Spanish version of Transition from Preschool Early Intervention to School Age Program – The Preschool Early Intervention program should include this form as an attachment to the Notice Of Your Child’s Transition to School Age Meeting.
Age:
Language:Spanish
Effective Date:
AVIS DE GARANTIES PROCÉDURALES
Procedural Safeguards Notice – Preschool Early Intervention form revised June 2009. The request forms for mediation and due process hearing are included as Appendix B in this document. They can also be downloaded from the Preschool EI Forms page on the PaTTAN website.
Age:Preschool
Language:French
Effective Date:1/1/0001 12:00:00 AM
Chinese version of the Procedural Safeguards Notice used by Early Intervention Preschool Programs. This form was revised in July of 2008.
Age:Preschool
Language:Chinese
Effective Date:1/1/0001 12:00:00 AM
Korean version of the Procedural Safeguards Notice used by Early Intervention Preschool Programs. This form was revised in July of 2008.
Age:Preschool
Language:Korean
Effective Date:1/1/0001 12:00:00 AM
Arabic Version of the Procedural Safeguards Notice - Preschool Early Intervention.
Age:Preschool
Language:Arabic
Effective Date:1/1/0001 12:00:00 AM
Russian Version of the Procedural Safeguards Notice - Preschool Early Intervention.
Age:Preschool
Language:Russian
Effective Date:1/1/0001 12:00:00 AM
Vietnamese Version of the Procedural Safeguards Notice - Preschool Early Intervention.
Age:Preschool
Language:Vietnamese
Effective Date:1/1/0001 12:00:00 AM
Transition meeting invitation letter for children and families anticipating transition to a community program or leaving early intervention. Form updated 05/09
Age:
Language:English
Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. This form is used to invite team members to an IEP or other meeting.
Age:Preschool
Language:English
Effective Date:1/1/0001 12:00:00 AM
Arabic Version of the Preschool Early Intervention Invitation to Participate in the IEP Team Meeting or Other Meeting form.
Age:Preschool
Language:Arabic
Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. This form is used to invite team members to an IEP or other meeting. 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
Effective Date:1/1/0001 12:00:00 AM
Transition from Preschool Early Intervention to School Age Program – The Preschool Early Intervention program should include this form as an attachment to the Notice Of Your Child’s Transition to School Age Meeting. 10/2009
Age:
Language:English
Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. The Preschool Early Intervention program is responsible for sending this form on or before February 1st to the parents of all children approaching the age of kindergarten or 1st grade.
Age:
Language:English
Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. This form is used along with an Invitation to Participate in an IEP Meeting if there are team members who are invited to attend but the program would like to excuse their participation.
Age:Preschool
Language:English
Effective Date:1/1/0001 12:00:00 AM
Arabic Version of the Preschool Early Intervention Parental Consent to Excuse Members from Attending the IEP Team Meeting form.
Age:Preschool
Language:Arabic
Effective Date:1/1/0001 12:00:00 AM
This annotated document describes the contents of the Parental Consent to Excuse Members from Attending the IEP Team Meeting form. This form is effective beginning March 2014. This form is used along with an Invitation to Participate in an IEP Meeting if there are team members who are invited to attend but the program would like to excuse their participation. 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
Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. This form must be issued by the Local Education Agency to obtain written consent to conduct an initial evaluation.
Age:Preschool
Language:English
Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. This form must be issued by the Local Education Agency to obtain written consent to conduct an initial evaluation. This is the annotated version. 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
Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. This form must be issued by the Local Education Agency to obtain written consent to conduct a reevaluation.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
Effective Date:1/1/0001 12:00:00 AM
Letters 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:English
Effective Date:1/1/0001 12:00:00 AM
This form allows parents to choose whether to give consent for the Local Educational Agency (LEA) to access reimbursement from Medical Assistance for special education services.
Age:Preschool,Infant/Toddler
Language:English
Effective Date:1/1/0001 12:00:00 AM
The Formal Complaint Form/Contact Information for (Infant Toddler and Preschool) is a form that parents can complete to request a formal complaint through the Bureau of Early Intervention Services.
Age:Infant/Toddler,Preschool
Language:English