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: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:5/16/2018 12:00:00 AM
This form summarizes the parent and child’s rights during the Early Intervention process.
Age:Infant/Toddler
Language:English
Effective Date:5/16/2018 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
Effective Date:5/16/2018 1:35:08 PM
This is the Chinese version of the form that summarizes the parent and child’s rights during the Early Intervention process.
Age:Infant/Toddler
Language:Chinese
Effective Date:1/31/2018 11:00:00 PM
Arabic Parent Rights Agreement form used by Early Intervention Infant/Toddler programs starting July 1, 2012.
Age:Infant/Toddler
Language:Arabic
Effective Date:1/21/2018 11:00:00 PM
Croatian Parent Rights Agreement form used by Early Intervention Infant/Toddler programs starting July 1, 2012.
Age:Infant/Toddler
Language:Croatian
Effective Date:11/30/2014 11:00:00 PM
Parent Rights Agreement form used by Early Intervention Infant/Toddler programs starting July 1, 2012. Nepali Version.
Age:Infant/Toddler
Language:Nepali