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:11/1/2023 8:30:25 AM
The Prior Written Notice for a Reevaluation and Request for Consent form has been separated into two forms, the Prior Written Notice for a Reevaluation form and the Request for Consent for a Reevaluation form. The form was separated into two forms to ensure LEAs provide parents with prior written notice and obtain parent consent at proper times during the reevaluation process in accordance with 34 CFR 300.300 and 300.503.
Age:School Age
Language:Vietnamese
Effective Date:6/30/2008 11:00:00 PM
SUMMARY OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE - School Age
Este formulario entrará en vigor el 1° de julio de 2008. Este Resumen de Logros Académicos y Desempeño Funcional (con un pie de página que indica “Revisiones de julio de 2008”) sustituye al Resumen de Desempeño del Alumno actual. Versión con acotaciones disponible
Age:School Age
Language:Spanish
Effective Date:6/30/2008 11:00:00 PM
SUMMARY OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE - School Age
Questo modulo entra in vigore a partire dal 1 ° luglio 2008. Questa Sintesi dello Svolgimento Accademico e del Rendimento Funzionale rivisto (con un piè di pagina che indica "Revisioni Luglio 2008") sostituisce l'attuale Riepilogo del Rendimento degli Studenti. Disponibile la Versione annotata.
Age:School Age
Language:Italian
Effective Date:6/30/2008 11:00:00 PM
PARENTAL CONSENT TO EXCUSE MEMBERS FROM ATTENDING THE IEP TEAM MEETING - School Age
Ovaj obrazac je na snazi od 1. srpnja 2008. i odražava nove odredbe revidiranih Poglavlja 14 i 711. Ovaj novi poziv (s podnožjem uz naznaku “Revizije iz srpnja 2008.”) zamjenjuje trenutačni ER. Ovaj poziv ne sadrži zahtjev za roditeljski pristanak za izuzeće članova tima IEP u sudjelovanju na sastanku tima IEP. Ovaj zahtjev se sada pravi s posebnim obrascem “Roditeljski pristanak za izuzeće članova u sudjelovanju na sastanku tima IEP”. Dostupna je objavljena verzija
Age:School Age
Language:Croatian
Effective Date:9/14/2020 7:25:55 AM
This document provides guidance to Infant Toddler Early Intervention Service Coordinators on discussing enrollment in Pennsylvania’s Medical Assistance program with families.
Age:Infant/Toddler
Language:English
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
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:Chinese
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:Spanish
Effective Date:6/30/2008 11:00:00 PM
AGREEMENT TO WAIVE REEVALUATION - School Age
Ovaj obrazac stupa na snagu od 1. srpnja 2008. Ovaj novi obrazac koristi se za dobivanje roditeljskog sporazuma o odricanju od ponovnog ocjenjivanja. Ovaj je zahtjev prethodno uključen u obrazac “Dopuštenje za ponovno ocjenjivanje/Sporazum o odricanju od ponovnog ocjenjivanja”. Dostupna je objavljena verzija
Age:School Age
Language:Croatian
Effective Date:12/14/2020 2:33:51 PM
This form is effective December 14, 2020. This revised Summary of Academic Achievement and Functional Performance (with a footer indicating “December 2020”) includes the addition of an Act 26 data collection question.
Age:School Age
Language:English