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.

Results 71-76 of 76
Reevaluation Report -Annotated cover image

Reevaluation Report -Annotated

Effective Date:7/1/2018 8:41:03 AM
This annotated form described the contents of the revised Reevaluation Report (July 2018), which 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:English
Service Coordination Checklist for Providing Information to Families about Medical Assistance cover image

Service Coordination Checklist for Providing Information to Families about Medical Assistance

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
Special Education State Complaint Resolution Procedures cover image

Special Education State Complaint Resolution Procedures

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
Summary of Academic Achievement and Functional Performance cover image

Summary of Academic Achievement and Functional Performance

Effective Date:12/14/2020 1:33:51 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
Summary of Academic Achievement and Functional Performance (Annotated) cover image

Summary of Academic Achievement and Functional Performance (Annotated)

Effective Date:12/14/2020 7:42:58 AM
This annotated document is effective December 14, 2020. This revised annotated Summary of Academic Achievement and Functional Performance (with a footer indicating “December 2020”) includes the addition of an Act 26 data collection question and related guidance.
Age:School Age
Language:English
Transition to Community Letter  cover image

Transition to Community Letter

Effective Date:1/1/0001 12:00:00 AM
Transition meeting invitation letter for children and families anticipating transition to a community program or leaving early intervention. Form updated 05/09
Age:
Language:English