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:12/1/2018 10:27:21 AM
Infant Toddler Early Intervention Evaluation Report for use as of December 2018. The Evaluation Report documents information on a child and family, including strengths and needs, provides eligibility determinations, and provides recommendations for supports that can assist the young child to develop, learn and grow.
Age:Infant/Toddler
Language:Haitian Creole
Effective Date:12/1/2018 12:00:00 AM
Early Intervention Evaluation Report in Spanish for use as of December 2018. The Evaluation Report documents information on a child and family, including strengths and needs, provides eligibility determinations, and provides recommendations for supports that can assist the young child to develop, learn and grow.
Age:Infant/Toddler
Language:Spanish
Effective Date:12/1/2018 11:30:05 AM
The Infant Toddler Tracking Plan is used by local Infant Toddler Early Intervention programs to identify the supports provided to children and families involved in PA’s Early Intervention tracking program.
Age:Infant/Toddler
Language:English
Effective Date:12/1/2022 1:23:08 PM
The Infant Toddler Tracking Plan used by local Infant Toddler Early Intervention programs is used to identify the supports provided to children and families involved in PA’s Early Intervention tracking program.
Age:Infant/Toddler
Language:Haitian Creole
Effective Date:12/1/2018 11:33:59 AM
The annotated version of the Infant Toddler Tracking plan provides guidance to staff completing the plan used identifying the supports provided to children and families involved in PA’s Early Intervention tracking program. It is not intended as an exclusive manner for complying with state and/or federal Early Intervention statutes and regulations.
Age:Infant/Toddler
Language:English
Effective Date:12/1/2018 11:36:24 AM
The Spanish version of the Infant Toddler Tracking plan is used by local Infant Toddler Early Intervention programs to identify the supports provided to children and families involved in PA’s Early Intervention tracking program.
Age:Infant/Toddler
Language:Spanish
Effective Date:1/1/0001 12:00:00 AM
Letters of invitation for transition to the Preschool EI Program or to other community services. Invitation letters must be sent to the family, Preschool EI Program and other participants no later than 30 days before the scheduled transition meeting date, unless the parties all agree to meet within shorter timelines.
Age:Infant/Toddler,Preschool
Language:English
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