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:10/14/2022 9:27:02 AM
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 July 2022. At that time changes were made in Sections l, lll, and IV. Sections have been reduced to Sections l and Section ll. Section l: Language and Communication Needs, includes a sign-in area for contributors, asks for data to support conclusions and includes a chart to address primary language and communication mode. Section lll has updated the language for assistive technology, devices, and services. Section lll requires the team to examine if the student has appropriate academic language and communication skills to participate in and access curriculum and instruction. Section lV, Full Range of Needs, has been made into a question thus requiring more discussion. Glossary terms have also been added, revised or deleted as appropriate. The revised plan has a footer reading October 14, 2022. Annotated version available
Age:School Age
Language:English
Effective Date:10/14/2022 9:30:35 AM
The primary purpose of the Communication Plan is to establish discussion among all IEP team members who review the student’s needs based on communication skills and access. The Communication Plan should be the starting point for the IEP, and the results of this discussion should be used to identify the student’s present educational levels as well as to complete other sections of the IEP. The Annotated Communication Plan was revised in July 2022. At that time changes were made in Sections l, lll, and IV. Sections have been reduced to l and ll. Changes have been made in the following areas: Section l, including assessments and data to determine the student’s language and communication mode, and a revised chart to inform the school team of the student’s preferred method for learning and communication. Section ll, describe how the student is accessing grade level curriculum and instruction, and how is it delivered directly to the student using preferred language and communication mode. Glossary terms have also been added, revised, or deleted as appropriate. The revised version has October 14, 2022 in the footer.
Age:School Age
Language:English
Effective Date:7/2/2008 12:00:00 AM
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 July 2022. At that time changes were made in Sections l, lll, and IV. Sections have been reduced to Sections l and Section ll. Section l: Language and Communication Needs, includes a sign-in area for contributors, asks for data to support conclusions and includes a chart to address primary language and communication mode. Section lll has updated the language for assistive technology, devices, and services. Section lll requires the team to examine if the student has appropriate academic language and communication skills to participate in and access curriculum and instruction. Section lV, Full Range of Needs, has been made into a question thus requiring more discussion. Glossary terms have also been added, revised or deleted as appropriate. The revised plan has a footer reading October 14, 2022. Annotated version available
Age:School Age
Language:Italian
Effective Date:7/2/2008 12:00:00 AM
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 July 2022. At that time changes were made in Sections l, lll, and IV. Sections have been reduced to Sections l and Section ll. Section l: Language and Communication Needs, includes a sign-in area for contributors, asks for data to support conclusions and includes a chart to address primary language and communication mode. Section lll has updated the language for assistive technology, devices, and services. Section lll requires the team to examine if the student has appropriate academic language and communication skills to participate in and access curriculum and instruction. Section lV, Full Range of Needs, has been made into a question thus requiring more discussion. Glossary terms have also been added, revised or deleted as appropriate. The revised plan has a footer reading October 14, 2022. Annotated version available
Age:School Age
Language:Russian
Effective Date:7/2/2008 12:00:00 AM
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 July 2022. At that time changes were made in Sections l, lll, and IV. Sections have been reduced to Sections l and Section ll. Section l: Language and Communication Needs, includes a sign-in area for contributors, asks for data to support conclusions and includes a chart to address primary language and communication mode. Section lll has updated the language for assistive technology, devices, and services. Section lll requires the team to examine if the student has appropriate academic language and communication skills to participate in and access curriculum and instruction. Section lV, Full Range of Needs, has been made into a question thus requiring more discussion. Glossary terms have also been added, revised or deleted as appropriate. The revised plan has a footer reading October 14, 2022. Annotated version available
Age:School Age
Language:Spanish
Effective Date:12/1/2010 12:00:00 AM
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 July 2022. At that time changes were made in Sections l, lll, and IV. Sections have been reduced to Sections l and Section ll. Section l: Language and Communication Needs, includes a sign-in area for contributors, asks for data to support conclusions and includes a chart to address primary language and communication mode. Section lll has updated the language for assistive technology, devices, and services. Section lll requires the team to examine if the student has appropriate academic language and communication skills to participate in and access curriculum and instruction. Section lV, Full Range of Needs, has been made into a question thus requiring more discussion. Glossary terms have also been added, revised or deleted as appropriate. The revised plan has a footer reading October 14, 2022. Annotated version available
Age:School Age
Language:Ukranian
Effective Date:12/1/2010 12:00:00 AM
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 July 2022. At that time changes were made in Sections l, lll, and IV. Sections have been reduced to Sections l and Section ll. Section l: Language and Communication Needs, includes a sign-in area for contributors, asks for data to support conclusions and includes a chart to address primary language and communication mode. Section lll has updated the language for assistive technology, devices, and services. Section lll requires the team to examine if the student has appropriate academic language and communication skills to participate in and access curriculum and instruction. Section lV, Full Range of Needs, has been made into a question thus requiring more discussion. Glossary terms have also been added, revised or deleted as appropriate. The revised plan has a footer reading October 14, 2022. Annotated version available
Age:School Age
Language:Urdu
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
Effective Date:7/1/2018 12:00:00 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:French
Effective Date:12/2/2016 12:00:00 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
Language:Spanish