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:2/1/2020 11:30:38 AM
ІНДИВІДУАЛІЗОВАНА ОСВІТНЯ ПРОГРАММА (ІОП) This revised form (with footer February 1, 2020) provides changes to section IV (the elimination of required video recording and narrative notes for students taking the PASA) per the PENN*LINK issued December 16, 2019.
Age:School Age
Language:Ukranian
Effective Date:2/1/2020 11:31:10 AM
CHƯƠNG TRÌNH GIÁO DỤC CÁ NHÂN HOÁ (IEP) This revised form (with footer February 1, 2020) provides changes to section IV (the elimination of required video recording and narrative notes for students taking the PASA) per the PENN*LINK issued December 16, 2019.
Age:School Age
Language:Vietnamese
Effective Date:2/1/2020 8:51:43 AM
Age:School Age
Language:Arabic
Effective Date:2/1/2020 8:35:41 AM
גיל בית ספר Revised IEP February 1, 2020 – This revised form (with footer February 1, 2020) provides changes to section IV (the elimination of required video recording and narrative notes for students taking the PASA) per the PENN*LINK issued December 16, 2019.
Age:School Age
Language:Hebrew
Effective Date:12/1/2016 11:00:00 PM
Evaluation Report (Annotated)—School Age
Este documento con acotaciones describe el contenido del Informe de Evaluación, el cual se llena para documentar el proceso en el cual un equipo de evaluación, definido en las regulaciones federales y estatales como un grupo de profesionales calificados, así como y el/los padre(s) del alumno, determinan si el alumno sufre de una discapacidad y tiene necesidad de los servicios de educación especial. Este formulario se utiliza únicamente cuando se hace una evaluación a un alumno que todavía no es identificado como estudiante en edad escolar para recibir educación especial.
Age:School Age
Language:Spanish
Effective Date:2/1/2014 9:30:01 AM
INTENTO DE INSCRIBIRSE - ELEGIBLE PARA EL PRIMER GRADO (EDAD DE PRINCIPIANTES) Description: Spanish version of the Intent to Register for first grade eligible children - The Preschool Early Intervention program is to provide this form to the parent at the Transition meeting (that is to be held by the end of February) and is to be completed jointly by the preschool and the school district or charter school.
Age:School Age,Preschool
Language:Spanish
Effective Date:2/1/2014 1:00:00 AM
This form is effective beginning March 2014. The Preschool Early Intervention program is to provide this form to the parent at the Transition meeting (that is to be held by the end of February) and is to be completed jointly by the preschool and the school district or charter school.
Age:School Age,Preschool
Language:English
Effective Date:2/1/2014 1:00:00 AM
This form is effective beginning March 2014. The Preschool Early Intervention program is to provide this form to the parent at the Transition meeting (that is to be held by the end of February) and is to be completed jointly by the preschool and the school district or charter school. This annotated form offers assistance and guidance to parents and early intervention providers. It is not intended as an exclusive manner for complying with state and/or federal special education statutes and regulations.
Age:School Age,Preschool
Language:English
Effective Date:6/29/2015 11:00:00 PM
INVITATION TO PARTICIPATE IN THE IEP TEAM MEETING OR OTHER MEETING - School Age
Revisado en mayo de 2015 – Esta nueva Invitación para Participar en la Reunión u otras Reuniones del Equipo IEP (con el pie de página que indica “Revisiones de mayo de 2015”) sustituye la Invitación actual. Este formulario revisado agrega objetivos suplementarios para una reunión del equipo IEP, elimina el requisito para usar dos invitaciones por separado para participar en la reunión del Equipo IEP u otros tipos de reuniones para la planificación y/o los servicios de transición, y complementa las explicaciones de la planificación y los servicios de transición, incluida una declaración referente a que la agencia de educación local (LEA) invitará al alumno, en caso de tener 14 años de edad o mayores. Este formulario entrará en vigor el 30 de junio de 2015. Versión con acotaciones disponible
Age:School Age
Language:Spanish
Effective Date:6/29/2015 11:00:00 PM
INVITATION TO PARTICIPATE IN THE IEP TEAM MEETING OR OTHER MEETING - School Age
Révisé en mai 2015 - Cette nouvelle invitation à participer à la réunion de l'équipe IEP ou à une autre réunion (avec le pied de page indiquant «Révisions de mai 2015») remplace l'invitation en cours. Ce formulaire révisé ajoute des objectifs supplémentaires pour une réunion de l'équipe IEP, supprime l'obligation d'utiliser deux invitations distinctes pour participer à la réunion de l'équipe IEP ou d'autres formulaires de réunion pour la planification/les services de transition et complète les explications pour la planification et les services de transition, y compris une déclaration que l'agence locale d'éducation (ALE) invitera l'élève, s’il a 14 ans ou plus. Ce formulaire prend effet le 30 juin 2015. Version annotée disponible
Age:School Age
Language:French