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:7/1/2023 1:19:30 PM
The standardized session note form is to be used by all Infant/Toddler Early Intervention programs. The session note reflects the Key Principles of Early Intervention in PA. It documents the provision of services and supports, assures communication with families or caregivers, and provides a mechanism to monitor the progress toward the Individualized Family Service Plan (IFSP) outcomes/goals.
Age:Infant/Toddler
Language:Spanish
Effective Date:6/30/2008 11:00:00 PM
AGREEMENT TO WAIVE REEVALUATION - School Age
Ce formulaire prend effet le 1er juillet 2008. Ce nouveau formulaire permet d'obtenir un accord parental pour renoncer à une réévaluation. Cette demande a déjà été incluse dans le formulaire «Autorisation de réévaluation/Accord de renonciation à la réévaluation». Version annotée disponible.
Age:School Age
Language:French
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:6/30/2008 11:00:00 PM
This form is effective beginning July 1, 2008. This new form is used to obtain parental agreement to waiving a reevaluation. This request previously was included in the "Permission to Reevaluate/Agreement to Waive Reevaluation" form.
Age:School Age
Language:English
Effective Date:6/30/2008 11:00:00 PM
CONSENSO ALL’ESONERO DELLA RIVALUTAZIONE – This form is effective beginning July 1, 2008. This new form is used to obtain parental agreement to waiving a reevaluation. This request previously was included in the "Permission to Reevaluate/Agreement to Waive Reevaluation" form.
Age:School Age
Language:Italian
Effective Date:7/1/2018 8:41:03 AM
This annotated document describes the contents of the Agreement to Waive Reevaluation form, which is used by the LEA to obtain agreement from the parent to waive a child’s reevaluation. This document also replaces the September 2008 version and includes a change in terminology that replaces the term “mental retardation” with the term “intellectual disability.” This change aligns the Commonwealth’s special education regulations in Chapter 14 and Chapter 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:6/1/2008 1:31:52 PM
Agreement to Waive Re-evaluation (Haitian Creole)
Age:School Age
Language:Haitian Creole
Effective Date:2/1/2020 2:47:42 PM
This annotated document provides guidance on the development of the Individual Education Program and includes guidance pertaining to the October 2020 revision to Act 26 related to postsecondary transition. Note: The annotated IEP was reformatted on June 14, 2021. Features were added to enhance navigation, search capabilities, and previewing individual sections. The content did not change. Users may select the “Interactive Annotated IEP” or the “ADA Compliant Annotated IEP.”
Age:School Age
Language:English
Effective Date:12/14/2020 2:41:40 PM
This annotated document provides guidance on the development of the Individual Education Program and includes guidance pertaining to the October 2020 revision to Act 26 related to postsecondary transition as well as any school closures as a result of COVID-19. Note: The annotated IEP was reformatted on June 14, 2021. Features were added to enhance navigation, search capabilities, and previewing individual sections. The content did not change. Users may select the “Interactive Annotated IEP with COVID-19 Guidance” or the “ADA Compliant Annotated IEP with COVID-19 Guidance.”
Age:School Age
Language:English