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 ⏷
Effective Date:10/1/2016 2:53:37 PM
This Portuguese version of the form should be issued by the Preschool Early Intervention programs to obtain written consent to conduct a reevaluation.
Age:Preschool
Language:Portuguese
Effective Date:10/1/2016 12:00:00 AM
This form is effective beginning October 2016. This form must be issued by the Local Education Agency to obtain written consent to conduct a reevaluation.
Age:Preschool
Language:English
Effective Date:10/1/2016 9:10:06 AM
Description: Spanish Version of the Preschool Early Intervention Permission to Re-Evaluate form. This form must be issued by the Local Education Agency to obtain written consent to conduct a reevaluation.
Age:Preschool
Language:Spanish
Effective Date:1/1/0001 12:00:00 AM
This form is effective beginning March 2014. This form must be issued by the Local Education Agency to obtain written consent to conduct a reevaluation.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:Preschool
Language:English
Effective Date:7/1/2008 11:00:00 PM
COMMUNICATION PLAN - School Age
Il Piano di Comunicazione deve essere incluso nell'IEP per ogni studente che è sordo o con problemi dell’udito. Il modulo del Piano di Comunicazione è stato controllato a dicembre 2010. A quel tempo addizioni vennero fatte alle sezioni I e III del Piano per includere i bisogni di comunicazione e i dispositivi tecnologici e i servizi necessari per gli studenti che sono sordi. Il Piano rivisto ha un piè di pagina che legge dicembre 2010. Disponibile la Versione annotata.
Age:School Age
Language:Italian
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
Effective Date:6/30/2015 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:Croatian
Effective Date:12/1/2018 12:00:00 AM
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:Preschool
Language:English
Effective Date:12/30/2018 9:26:48 AM
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:Preschool
Language:Albanian
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:Preschool
Language:Spanish