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.

Results 41-50 of 363
Evaluation Report (Hebrew) cover image

Evaluation Report (Hebrew)

Effective Date:7/1/2018 8:30:53 AM
גיל בית הספר 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:Hebrew
Evaluation Report (Indonesian) cover image

Evaluation Report (Indonesian)

Effective Date:7/1/2018 1:29:00 PM
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:Indonesian
Evaluation Report (Nepali) cover image

Evaluation Report (Nepali)

Effective Date:4/13/2023 8:04:21 AM
Age:School Age
Language:Nepali
Evaluation Report (Portuguese) cover image

Evaluation Report (Portuguese)

Effective Date:7/1/2018 8:30:15 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:Portuguese
Evaluation Report (Russian) cover image

Evaluation Report (Russian)

Effective Date:7/1/2018 12:00:00 AM
ОТЧЕТ ОБ ОЦЕНИВАНИИ (ER) — школьный возраст 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:Russian
Evaluation Report (Swahili) cover image

Evaluation Report (Swahili)

Effective Date:7/1/2018 10:43:11 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:Swahili
Evaluation Report-Annotated cover image

Evaluation Report-Annotated

Effective Date:7/1/2018 8:41:03 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:English
FTESË PËR PJESËMARRJE NË MBLEDHJEN E EKIPIT IEP OSE NË NJË MBLEDHJE TJETËR - Mosha shkollore cover image

FTESË PËR PJESËMARRJE NË MBLEDHJEN E EKIPIT IEP OSE NË NJË MBLEDHJE TJETËR - Mosha shkollore

Effective Date:6/29/2015 11:00:00 PM
INVITATION TO PARTICIPATE IN THE IEP TEAM MEETING OR OTHER MEETING - School Age Ribotuar në maj 2015 - Kjo Ftesë e re për Pjesëmarrje në Mbledhjen e Ekipit IEP ose në një Mbledhje Tjetër (me shënim në fund që shkruan "Ribotim, Maj 2015") zëvendëson ftesën aktuale. Ky formular i ribotuar shton synime të reja për mbledhjet IEP, heq kushtin për përdorimin e dy formularëve të ndryshëm të Ftesave për Pjesëmarrje në Mbledhjen e Ekipit IEP ose në një Mbledhje Tjetër për planifikimin/shërbimet e tranzicionit, dhe zgjeron shpjegimet mbi planifikimin e shërbimet e tranzicionit, përfshirë deklaratë që qendra lokale e arsimit (LEA) do të ftojë nxënësin nëse është 14 vjeç e sipër. Ky formular hyn në fuqi në 30 qershor, 2008. Versioni i shpjeguar në dispozicion
Age:School Age
Language:Albanian
IEP ٹیم کی میٹنگ یا دیگر میٹنگ میں شرکت کی دعوت - اسکولی عمر cover image

IEP ٹیم کی میٹنگ یا دیگر میٹنگ میں شرکت کی دعوت - اسکولی عمر

Effective Date:6/29/2015 11:00:00 PM
INVITATION TO PARTICIPATE IN THE IEP TEAM MEETING OR OTHER MEETING - School Age

ترمیم شدہ مئی 2015 – IEP ٹیم میٹنگ یا دیگر میٹنگ میں شرکت کے لیے یہ نیا دعوت نامہ (جس کے فوٹر میں "مئی 2015 ترامیم" درج ہے) موجودہ دعوت نامے کی جگہ لیتاہے۔ یہ ترمیم شدہ فارم IEP ٹیم میٹنگ کے لیے تکملاتی مقاصد شامل کرتا ہے، IEP ٹیم میٹنگ میں شرکت یا منتقلی کی منصوبہ بندی/ خدمات سے متعلق دیگر میٹنگ کے فارموں کے لیے دو علیحدہ دعوت نامے استعمال کرنے کے تقاضے کو ختم کرتا ہے، اور منتقلی کی منصوبہ بندی اور خدمات کی وضاحت کا اضافہ کرتا ہے، بشمول اس بیان کے کہ مقامی تعلیمی ایجنسی (LEA) طالب علم کو مدعو کرے گی، اگر اس کی عمر 14 سال یا زیادہ ہو۔ یہ فارم 30 جون، 2008 سے مؤثر ہے۔ شرح کے ساتھ ورژن دستیاب ہے

Age:School Age
Language:Urdu
IEP टोली बैठक वा अन्य बैठकमा सहभागी हुन आमन्त्रण - विद्यालय जाने उमेर cover image

IEP टोली बैठक वा अन्य बैठकमा सहभागी हुन आमन्त्रण - विद्यालय जाने उमेर

Effective Date:6/29/2015 11:00:00 PM
INVITATION TO PARTICIPATE IN THE IEP TEAM MEETING OR OTHER MEETING - School Age संशोधित मे 2015 – IEP टोली बैठक वा अन्य बैठकमा (“मे 2015 संशोधनहरू”मा संकेत गरिएको पादलेख सहित) मा सहभागी हुन यस नयाँ आमन्त्रणले हालको आमन्त्रणलाई प्रतिस्थापन गर्छ। यस संशोधित फारामले IEP टोली बैठकका पूरक उद्देश्यहरूलाई थप्दछ, IEP टोली बैठक वा पारगमन योजना/सेवाहरूका लागि निर्मित अन्य बैठकमा सहभागी हुन छुट्टै आमन्त्रणको प्रयोग गर्ने आवश्यकतालाई हटाउँछ र विद्यार्थीको उमेर 14 वर्ष वा सोभन्दा बढी भएमा स्थानीय शिक्षा निकाय (LEA) आमन्त्रण गर्ने कथन सहित पारगमन योजना तथा सेवाहरूको व्याख्याहरूलाई पूरक गर्छ। यो फाराम मङ्गलवार, जून 30, 2015 को सुरुवात देखि प्रभावकारी छ। व्याख्या गरिएको संस्करण उपलब्ध छ
Age:School Age
Language:Nepali