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:7/1/2023 1:19:30 PM
The standardized session note form is to be used by all Infant/Toddler Early Intervention programs. The session note reflects the Key Principles of Early Intervention in PA. It documents the provision of services and supports, assures communication with families or caregivers, and provides a mechanism to monitor the progress toward the Individualized Family Service Plan (IFSP) outcomes/goals.
Age:Infant/Toddler
Language:Spanish
Effective Date:5/28/2018 1:00:00 AM
This standard release form is used to obtain permission to share information with community agencies who are currently involved with local Early Intervention programs.
Age:Infant/Toddler,Preschool
Language:English
Effective Date:5/4/2018 2:17:07 PM
This is the Spanish version of the standard release form used to obtain permission to share information with community agencies who are currently involved with local Early Intervention programs.
Age:Preschool,Infant/Toddler
Language:Spanish
Effective Date:5/18/2020 1:46:13 PM
This is the Spanish version of the standard release form that will allow Early Intervention and the Department of Health to exchange information with a family of a child who is deaf or hard of hearing.
Age:Infant/Toddler
Language:Spanish
Effective Date:5/20/2020 2:29:16 PM
A standard release form that will allow Early Intervention and the Department of Health to exchange information with a family of a child who is deaf or hard of hearing.
Age:Infant/Toddler
Language:English
Effective Date:1/1/0001 12:00:00 AM
The Formal Complaint Form/Contact Information for (Infant Toddler and Preschool) is a form that parents can complete to request a formal complaint through the Bureau of Early Intervention Services.
Age:Infant/Toddler,Preschool
Language:English
Effective Date:7/1/2023 11:11:32 AM
This standardized session note form is to be used by all Infant/Toddler Early Intervention programs. The session note reflects the Key Principles of Early Intervention in PA. It documents the provision of services and supports, assures communication with families or caregivers, and provides a mechanism to monitor the progress toward the Individualized Family Service Plan (IFSP) outcomes/goals.
Age:Infant/Toddler
Language:English
Effective Date:7/1/2023 11:13:55 AM
This document provides annotated guidance for using the Early Intervention session note form. The session note reflects the Key Principles of Early Intervention in PA. It documents the provision of services and supports, assures communication with families or caregivers, and provides a mechanism to monitor the progress toward the Individualized Family Service Plan (IFSP) outcomes/goals
Age:Infant/Toddler
Language:English
Effective Date:
Vietnamese Version of the Infant/Toddler Early Intervention Evaluation Report.
Age:Infant/Toddler
Language:Vietnamese
Effective Date:12/1/2022 2:32:42 PM
The Individualized Family Service Plan (IFSP) is a plan that identify services and supports for infants and toddlers and their families involved in Early Intervention. The IFSP considers the strengths of the child and concerns of the parent/guardian and most recent evaluation results so that family members and early education programs are actively engaged in promoting the child’s learning and development.
Age:Infant/Toddler
Language:English