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.


IEP in Braille

Download the Nemeth format ⏷

Download the UEB format ⏷

Results 21-30 of 198
Communication Plan for a Child Who Is Deaf or Hard of Hearing (Annotated) - School Age cover image

Communication Plan for a Child Who Is Deaf or Hard of Hearing (Annotated) - School Age

Effective Date:10/14/2022 9:30:35 AM
The primary purpose of the Communication Plan is to establish discussion among all IEP team members who review the student’s needs based on communication skills and access. The Communication Plan should be the starting point for the IEP, and the results of this discussion should be used to identify the student’s present educational levels as well as to complete other sections of the IEP. The Annotated Communication Plan was revised in July 2022. At that time changes were made in Sections l, lll, and IV. Sections have been reduced to l and ll. Changes have been made in the following areas: Section l, including assessments and data to determine the student’s language and communication mode, and a revised chart to inform the school team of the student’s preferred method for learning and communication. Section ll, describe how the student is accessing grade level curriculum and instruction, and how is it delivered directly to the student using preferred language and communication mode. Glossary terms have also been added, revised, or deleted as appropriate. The revised version has October 14, 2022 in the footer.
Age:School Age
Language:English
CONSENSO GENITORIALE PER SCUSARE I MEMBRI DI PARTECIPARE ALL’ INCONTRO DELLA SQUADRA - ETÀ SCOLARE cover image

CONSENSO GENITORIALE PER SCUSARE I MEMBRI DI PARTECIPARE ALL’ INCONTRO DELLA SQUADRA - ETÀ SCOLARE

Effective Date:6/30/2008 11:00:00 PM
PARENTAL CONSENT TO EXCUSE MEMBERS FROM ATTENDING THE IEP TEAM MEETING - School Age Questo modulo entra in vigore a partire dal 1 ° luglio 2008 e riflette nuove disposizioni dei capitoli 14 e 711 rivisti. Questo nuovo invito (con un piè di pagina che indica "Revisioni di luglio 2008") sostituisce l'invito attuale. Questo invito non contiene più la richiesta di consenso dei genitori per scusare i membri della aquadra IEP di partecipare all’incontro della aquadra IEP. Questa richiesta è ora fatta con un modulo separato, "Consenso genitoriale per scusare i membri di partecipare all’ incontro della aquadra IEP". Disponibile la Versione annotata.
Age:School Age
Language:Italian
CONSENTIMIENTO DEL PADRE PARA EXCUSAR A UN MIEMBRO DEL EQUIPO DE ASISTIR A LA REUNIÓN DEL PROGRAMA DE EDUCACIÓN INDIVIDUALIZADO (IEP por sus siglas en inglés) - Edad escolar cover image

CONSENTIMIENTO DEL PADRE PARA EXCUSAR A UN MIEMBRO DEL EQUIPO DE ASISTIR A LA REUNIÓN DEL PROGRAMA DE EDUCACIÓN INDIVIDUALIZADO (IEP por sus siglas en inglés) - Edad escolar

Effective Date:6/30/2008 11:00:00 PM
PARENTAL CONSENT TO EXCUSE MEMBERS FROM ATTENDING THE IEP TEAM MEETING - School Age Este formulario entrará en vigor a partir del 1° de julio de 2008 y refleja las nuevas disposiciones de los Capítulos 14 y 711 revisados. Esta nueva Invitación (con un pie de página que indica “Revisiones de julio de 2008”) reemplaza a la Invitación actual. Esta Invitación ya no contiene la petición del consentimiento de los padres en cuanto a eximir a los miembros del equipo IEP de asistir a la reunión del equipo IEP. Esta petición ahora se hace con un formulario por separado, “Consentimiento de los Padres de Eximir a los Miembros de Asistir a la Reunión del Equipo IEP”. Versión con acotaciones disponible
Age:School Age
Language:Spanish
Invitation to Participate in the IEP Team Meeting or Other Meeting (German) cover image

Invitation to Participate in the IEP Team Meeting or Other Meeting (German)

Effective Date:6/15/2015 12:00:00 AM
Revised May 2015 – This new Invitation to Participate in the IEP Team Meeting or Other Meeting (with footer indicating “May 2015 Revisions”) replaces the current Invitation. This revised form adds supplementary purposes for an IEP team meeting, removes the requirement to use two separate Invitation to Participate in the IEP Team Meeting or Other Meeting forms for transition planning/services, and supplements the explanations for transition planning and services, including a statement that the local education agency (LEA) will invite the student, if age 14 or above. This form is effective beginning June 30, 2015.
Age:School Age
Language:German
Parental Consent to Excuse Members from Attending the Individualized Education Program (IEP) Team Meeting (German) cover image

Parental Consent to Excuse Members from Attending the Individualized Education Program (IEP) Team Meeting (German)

Effective Date:7/1/2008 12:00:00 AM
This form, effective beginning July 1, 2008, is to be used when the Local Education Agency (LEA) seeks to obtain consent from the parent to excuse required members of the IEP team from attending an IEP team meeting.
Age:School Age
Language:German
Evaluation Report  cover image

Evaluation Report

Effective Date:7/1/2018 8:41:03 AM
This revised Evaluation Report (July 2018) replaces the July 2008 version and 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 Chapters 14 and 711 to the Individuals with Disabilities Education Act (IDEA) regulatory revisions resulting from Rosa’s Law. The change in terminology does not affect the meaning or the eligibility determination associated with the term.
Age:School Age
Language:English
Evaluation Report (Arabic) cover image

Evaluation Report (Arabic)

Effective Date:4/13/2023 8:04:21 AM
Age:School Age
Language:Arabic
Evaluation Report (Bengali) cover image

Evaluation Report (Bengali)

Effective Date:7/1/2018 12:00:00 AM
Age:School Age
Language:Bengali
Evaluation Report (Chinese) cover image

Evaluation Report (Chinese)

Effective Date:7/1/2018 12:00:00 AM
Age:School Age
Language:Chinese
Evaluation Report (Haitian Creole) cover image

Evaluation Report (Haitian Creole)

Effective Date:7/1/2018 2:46:58 PM
This revised Evaluation Report (July 2018) replaces the July 2008 version and 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 Chapters 14 and 711 to the Individuals with Disabilities Education Act (IDEA) regulatory revisions resulting from Rosa’s Law. The change in terminology does not affect the meaning or the eligibility determination associated with the term.
Age:School Age
Language:Haitian Creole