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 on PDE's State Complaints and Dispute Resolution page.
State Complaint Forms in other languages are also available on the State Complaints and Dispute Resolution page.
Complaint Resolution Procedures
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.
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
Effective Date:1/1/0001 12:00:00 AM
The request forms for mediation and due process hearing are included as Appendix B in this document.
Age:Preschool
Language:French
Effective Date:1/1/0001 12:00:00 AM
Letter to a parent on their rights and their child’s rights related to early intervention services Chinese version.
Age:Preschool
Language:Chinese
Effective Date:1/1/0001 12:00:00 AM
Act 26 Questions and Answers
Age:
Language:English
Effective Date:1/1/0001 12:00:00 AM
AGREEMENT TO WAIVE REEVALUATION - School Age
Este formulario entrará en vigor a partir del 1° de julio de 2008. Este nuevo formulario se utiliza para obtener el acuerdo de los padres a fin de descartar la reevaluación. Esta solicitud se incluyó previamente en el formulario "Permiso para reevaluar / Acuerdo para renunciar a la reevaluación". Versión con acotaciones disponible
Age:School Age
Language:Spanish
Effective Date:1/1/0001 1:00:00 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. 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 1:00:00 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:Preschool
Language:English
Effective Date:6/1/2008 1:31:52 PM
Agreement to Waive Re-evaluation (Haitian Creole)
Age:School Age
Language:Haitian Creole