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:1/1/2026 9:29:34 AM
This form is effective beginning January 2026. The Preschool Early Intervention program is responsible for sending this form on or before February 1st to the parents of all children approaching the age of kindergarten or 1st grade.
Age:School Age,Preschool
Language:English
Effective Date:11/1/2029 12:00:00 AM
The Early Intervention Communication Plan, Bengali version, for use as of November 2019. The plan has detailed discussion points that families with children who are deaf or hard of hearing and IFSP or IEP team members should consider during plan development. Information in the plan addresses language and communication needs; communication options, opportunities for direct communication; and progress, assistive technology, devices and services. It also provides a glossary of terms for use.
Age:Infant/Toddler,Preschool
Language:Bengali
Effective Date:11/1/2019 12:00:00 AM
The Early Intervention Communication Plan, Haitian Creole version, for use as of November 2019. The plan has detailed discussion points that families with children who are deaf or hard of hearing and IFSP or IEP team members should consider during plan development. Information in the plan addresses language and communication needs; communication options, opportunities for direct communication; and progress, assistive technology, devices and services. It also provides a glossary of terms for use.
Age:Infant/Toddler,Preschool
Language:Haitian Creole
Effective Date:10/1/2016 12:00:00 AM
This form, Malayalam version, 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:Malayalam
Effective Date:10/1/2016 12:00:00 AM
This form, Swahili version, 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:Swahili
Effective Date:11/1/2017 12:00:00 AM
The PA MA Notice, Malayalam version, allows parents to choose whether to give consent for the Local Educational Agency (LEA) to access reimbursement from Medical Assistance for special education services. This 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,Infant/Toddler
Language:Malayalam
Effective Date:11/1/2017 12:00:00 AM
This form. Swahili version- allows parents to choose whether to give consent for the Local Educational Agency (LEA) to access reimbursement from Medical Assistance for special education services. This 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,Infant/Toddler
Language:Swahili
Effective Date:9/23/2025 12:00:00 AM
This form summarizes the parent and child’s rights during the Early Intervention process.
Age:Infant/Toddler
Language:Arabic
Effective Date:9/23/2025 12:00:00 AM
This form summarizes the parent and child’s rights during the Early Intervention process.
Age:Infant/Toddler
Language:Chinese
Effective Date:9/23/2025 12:00:00 AM
This is an annotated version of the Parent Rights Agreement that provides guidance to parents and Early Intervention staff for understanding parent and child’s rights during the Early Intervention process.
Age:Infant/Toddler
Language:English