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.

Results 91-100 of 198
PLAN DE COMUNICACIÓN PARA NIÑOS SORDOS O CON DISCAPACIDADES AUDITIVAS - Edad escolar   cover image

PLAN DE COMUNICACIÓN PARA NIÑOS SORDOS O CON DISCAPACIDADES AUDITIVAS - Edad escolar

Effective Date:7/2/2008 12:00:00 AM
COMMUNICATION PLAN - School Age El Plan de Comunicación debe ser incluido en el Programa de Educación Individualizada (IEP) de cualquier alumno que sea sordo o tenga problemas auditivos. El formulario del Plan de Comunicación fue revisado en diciembre de 2010. En ese entonces se hicieron adiciones en las Secciones I y III del plan con el fin de incluir las necesidades de comunicación y los dispositivos y servicios de tecnología auxiliar para los alumnos con sordoceguera. El plan revisado tiene un pie de página que dice Diciembre de 2010. Versión con acotaciones disponible
Age:School Age
Language:Spanish
POZIV ZA SUDJELOVANJE NA SASTANKU TIMA IEP ILI DRUGOM SASTANKU - Školska dob cover image

POZIV ZA SUDJELOVANJE NA SASTANKU TIMA IEP ILI DRUGOM SASTANKU - Školska dob

Effective Date:6/29/2015 11:00:00 PM
INVITATION TO PARTICIPATE IN THE IEP TEAM MEETING OR OTHER MEETING - School Age Revidirano u svibnju 2015. - Ovaj novi poziv za sudjelovanje na sastanku tima IEP ili drugom sastanku (s podnožjem uz naznaku “Revizije iz svibnja 2015”.) zamjenjuje trenutačni poziv. Ovaj revidirani obrazac dodaje dopunske svrhe za sastanak tima IEP, uklanja zahtjev za upotrebom dva odvojena obrasca poziva za sudjelovanje na sastanku tima IEP ili drugom sastanku za tranzicijsko planiranje/usluge i dopunjuje objašnjenja za tranzicijsko planiranje i usluge, uključujući izjavu da će lokalna agencija za obrazovanje (LEA) pozvati učenika, ako je dobi 14 godina ili stariji. Ovaj obrazac stupa na snagu od 30. lipnja 2015. Dostupna je objavljena verzija
Age:School Age
Language:Croatian
Preschool to School Age Transition Considerations for Children who are Deaf, Hard of Hearing or Deaf-Blind cover image

Preschool to School Age Transition Considerations for Children who are Deaf, Hard of Hearing or Deaf-Blind

Effective Date:10/31/2015 11:00:00 PM
Preschool to School Age Transition Considerations for Children who are Deaf, Hard of Hearing or Deaf-Blind
Age:School Age
Language:English
Prior Written Notice for a Reevaluation cover image

Prior Written Notice for a Reevaluation

Effective Date:11/1/2023 12:00:00 AM
The Prior Written Notice for a Reevaluation and Request for Consent form has been separated into two forms, the Prior Written Notice for a Reevaluation form and the Request for Consent for a Reevaluation form. The form was separated into two forms to ensure LEAs provide parents with prior written notice and obtain parent consent at proper times during the reevaluation process in accordance with 34 CFR 300.300 and 300.503.
Age:School Age
Language:English
Prior Written Notice for a Reevaluation (Annotated) cover image

Prior Written Notice for a Reevaluation (Annotated)

Effective Date:11/1/2023 12:00:00 AM
The Prior Written Notice for a Reevaluation and Request for Consent form has been separated into two forms, the Prior Written Notice for a Reevaluation form and the Request for Consent for a Reevaluation form. The form was separated into two forms to ensure LEAs provide parents with prior written notice and obtain parent consent at proper times during the reevaluation process in accordance with 34 CFR 300.300 and 300.503.
Age:School Age
Language:English
Prior Written Notice for Initial Evaluation (Bengali) cover image

Prior Written Notice for Initial Evaluation (Bengali)

Effective Date:4/13/2023 8:04:21 AM
Age:School Age
Language:Bengali
Prior Written Notice for Initial Evaluation and Request for Consent Form - School Age cover image

Prior Written Notice for Initial Evaluation and Request for Consent Form - School Age

Effective Date:3/29/2015 11:00:00 PM
This new form is effective beginning March 30, 2015 and reflects the requirement that initial evaluations are subject to the IDEA’s notice requirements in 34 CFR Sec. 300.503-300.504, and parental consent requirements in 34 CFR Sec. 300.300. Under 34 CFR Sec. 300.503(a) the local education agency (LEA) must provide written notice to the parents of a child with a disability that describes any evaluation procedures the agency proposes to conduct, and must be given to the parents of a child with a disability a reasonable time before the public agency: (1) Proposes to initiate or change the identification, evaluation or educational placement of the child or the provision of a free appropriate public education (FAPE) to the child; or (2) Refuses to initiate or change the identification, evaluation or educational placement of the child or the provision of FAPE to the child. This Prior Written Notice for Initial Evaluation and Request for Consent Form includes the notice and consent requirements for the initial evaluation. This form replaces the Permission to Evaluate – Consent Form. It contains the footer, “Revised January 2015.”
Age:School Age
Language:English
Prior Written Notice for Initial Evaluation and Request for Consent Form - School Age (Arabic) cover image

Prior Written Notice for Initial Evaluation and Request for Consent Form - School Age (Arabic)

Effective Date:3/30/2015 12:00:00 AM
This new form is effective beginning March 30, 2015 and reflects the requirement that initial evaluations are subject to the IDEA’s notice requirements in 34 CFR Sec. 300.503-300.504, and parental consent requirements in 34 CFR Sec. 300.300. Under 34 CFR Sec. 300.503(a) the local education agency (LEA) must provide written notice to the parents of a child with a disability that describes any evaluation procedures the agency proposes to conduct, and must be given to the parents of a child with a disability a reasonable time before the public agency: (1) Proposes to initiate or change the identification, evaluation or educational placement of the child or the provision of a free appropriate public education (FAPE) to the child; or (2) Refuses to initiate or change the identification, evaluation or educational placement of the child or the provision of FAPE to the child. This Prior Written Notice for Initial Evaluation and Request for Consent Form includes the notice and consent requirements for the initial evaluation. This form replaces the Permission to Evaluate – Consent Form. It contains the footer, “Revised January 2015.”
Age:School Age
Language:Arabic
Prior Written Notice for Initial Evaluation and Request for Consent Form (Annotated) - School Age cover image

Prior Written Notice for Initial Evaluation and Request for Consent Form (Annotated) - School Age

Effective Date:3/29/2015 11:00:00 PM
This annotated document describes the new Prior Written Notice for Initial Evaluation and Request for Consent Form, which reflects the requirement that initial evaluations are subject to the IDEA’s notice requirements in 34 CFR Sec. 300.503-300.504, and parental consent requirements in 34 CFR Sec. 300.300. Under 34 CFR Sec. 300.503(a) the local education agency (LEA) must provide written notice to the parents of a child with a disability that describes any evaluation procedures the agency proposes to conduct, and must be given to the parents of a child with a disability a reasonable time before the public agency: (1) Proposes to initiate or change the identification, evaluation or educational placement of the child or the provision of a free appropriate public education (FAPE) to the child; or (2) Refuses to initiate or change the identification, evaluation or educational placement of the child or the provision of FAPE to the child. This Prior Written Notice for Initial Evaluation and Request for Consent Form includes the notice and consent requirements for initial evaluation. This form replaces the Permission to Evaluate – Consent Form (Annotated). It contains the footer, “Revised January 2015.” This new form is effective beginning March 30, 2015.
Age:School Age
Language:English
Procedural Safeguards Letter  cover image

Procedural Safeguards Letter

Effective Date:7/1/2018 8:41:03 AM
This revised Procedural Safeguards Letter (with a footer indicating “July 2018 Revisions”) replaces the current Procedural Safeguards Letter dated July 1, 2008. This revised letter 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 Chapter 14 to the Individuals with Disabilities Education Act (IDEA) regulatory revisions resulting from Rosa’s Law. There are no other changes to the current regulations in Chapter 14 or 711.
Age:School Age
Language:English