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:11/16/2014 11:00:00 PM
NOTICE OF RECOMMENDED EDUCATIONAL PLACEMENT/PRIOR WRITTEN NOTICE (NOREP/PWN) - School Age
Este formulario de NOREP/PWN proporciona un formato que las agencias educativas locales (LEAs) pueden decidir comunicar a los padres el programa educativo recomendado para su hijo y otras acciones tomadas por la LEA. Esta NOREP/PWN revisada incluye recursos adicionales para los padres en la página 4. El formulario revisado contiene el pie de página “octubre de 2014”. Versión con acotaciones disponible
Age:School Age
Language:Spanish
Effective Date:3/29/2015 11:00:00 PM
Prior Written Notice for Initial Evaluation and Request for Consent Form - School Age
Este nuevo formulario entrará en vigor a partir del 30 de marzo de 2015 y refleja el requisito referente a que las evaluaciones iniciales estarán sujetas a los requisitos de aviso de la IDEA mencionados en 34 CFR Sec. 300.503-300.504, así como los requisitos de consentimiento de los padres mencionados en 34 CFR Sec. 300.300. Conforme a 34 CFR Sec. 300.503(a) la Agencia de Educación Local (LEA) deberá dar aviso por escrito a los padres del niño con discapacidad; tal aviso describirá el o los procedimientos de evaluación que la agencia se proponga realizar y deberá ser entregado a los padres del niño condiscapacidad antes de que la agencia pública:
(1) Se proponga iniciar o cambiar la identificación, evaluación o colocación educativa del niño o la disposición de la FAPE (Educación Pública Adecuada y Gratuita) para el niño; o
(2) Se rehúse a iniciar o cambiar la identificación, evaluación o colocación educativa del niño o la disposición de la FAPE para el niño.
Este Aviso Previo por Escrito para Evaluación Inicial y Petición del Formulario de Consentimiento incluye el aviso y los requisitos de consentimiento para la evaluación inicial. Este formulario sustituye el Permiso para Evaluar – Formulario de Consentimiento. En el pie de página se lee, “Revisado en enero de 2015”. Versión con acotaciones disponible
Age:School Age
Language:Spanish
Effective Date:11/16/2014 11:00:00 PM
NOTICE OF RECOMMENDED EDUCATIONAL PLACEMENT/PRIOR WRITTEN NOTICE (NOREP/PWN) - School Age
Ovaj obrazac NOREP/PWN daje oblik koji lokalne agencije za obrazovanje mogu odabrati za prenošenje roditeljima preporučenih obrazovnih programa za njihovo dijete i druge radnje koje poduzima LEA. Ovaj revidirani obrazac NOREP/PWN uključuje dodatne resurse za roditelje na stranici 4. Ovaj revidirani obrazac sadrži podnožje “Listopad 2014.” Dostupna je objavljena verzija
Age:School Age
Language:Croatian
Effective Date:6/30/2008 2:14:08 PM
KONSANTMAN PARAN POU DISPANSE PATISIPASYON MANM NAN REYINYON EKIP PWOGRAM EDIKASYON ENDIVIDYÈL (IEP) A
Age:School Age
Language:Haitian Creole
Effective Date:11/26/2014 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