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 ⏷

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Procedural Safeguards Notice (Uzbek)

Effective Date:4/28/2025 12:00:00 AM

The Procedural Safeguards Notice includes a full explanation of rights available to parents of a school age child with a disability when their child has been referred for or is receiving special education services. This model form provides a format that LEAs may choose to use to provide information about procedural safeguards to parents. This revised Procedural Safeguards Notice includes updated contact information and the Bureau of Special Education Complaint Information Packet and Form.

Age:School Age

Language:Uzbek

Procedural Safeguards Notice (Vietnamese)

Effective Date:4/28/2025 12:14:07 PM

Age:School Age

Language:Vietnamese

Procedural Safeguards Notice: Bengali

Effective Date:9/9/2025 12:00:00 AM

The Procedural Safeguards Notice, Bengali version, includes a full explanation of rights available to parents of a school age child with a disability when their child has been referred for or is receiving special education services. This model form provides a format that LEAs may choose to use to provide information about procedural safeguards to parents. This revised Procedural Safeguards Notice includes updated contact information and the Bureau of Special Education Complaint Information Packet and Form.

Age:School Age

Language:Bengali

REEVALUATION REPORT - School Age

Effective Date:12/1/2022 12:00:00 AM

This revised Reevaluation Report (December 2022) replaces the July 2018 version and includes updated language. The updated language does not affect the process that local education agencies follow regarding the completion of the Reevaluation Report.

Age:School Age

Language:English

Reevaluation Report (Annotated) - School Age

Effective Date:12/1/2022 12:00:00 AM

This annotated form describes the contents of the Reevaluation Report and includes updated language.

Age:School Age

Language:English

Reevaluation Report (Annotated) (Spanish)

Effective Date:12/2/2016 12:00:00 AM

This annotated form describes the contents of the Reevaluation Report and includes updated language.

Age:School Age

Language:Spanish

Reevaluation Report (Hebrew)

Effective Date:7/1/2018 8:46:04 AM

גיל בית הספר 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:Hebrew