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:6/30/2008 11:00:00 PM
CONSENSO ALL’ESONERO DELLA RIVALUTAZIONE – This form is effective beginning July 1, 2008. This new form is used to obtain parental agreement to waiving a reevaluation. This request previously was included in the "Permission to Reevaluate/Agreement to Waive Reevaluation" form.
Age:School Age
Language:Italian
Effective Date:7/1/2018 8:41:03 AM
This annotated document describes the contents of the Agreement to Waive Reevaluation form, which is used by the LEA to obtain agreement from the parent to waive a child’s reevaluation. This document also replaces the September 2008 version and includes a change in terminology that replaces the term “mental retardation” with the term “intellectual disability.” This change aligns the Commonwealth’s special education regulations in Chapter 14 and Chapter 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
Effective Date:6/1/2008 1:31:52 PM
Agreement to Waive Re-evaluation (Haitian Creole)
Age:School Age
Language:Haitian Creole
Effective Date:12/14/2020 2:41:40 PM
This annotated document provides guidance on the development of the Individual Education Program and includes guidance pertaining to the October 2020 revision to Act 26 related to postsecondary transition as well as any school closures as a result of COVID-19. Note: The annotated IEP was reformatted on June 14, 2021. Features were added to enhance navigation, search capabilities, and previewing individual sections. The content did not change. Users may select the “Interactive Annotated IEP with COVID-19 Guidance” or the “ADA Compliant Annotated IEP with COVID-19 Guidance.”
Age:School Age
Language:English
Effective Date:12/14/2020 3:39:48 PM
PROGRAMA DE EDUCACION INDIVIDUALIZADO (IEP, por sus siglas en inglés) (ANOTADA)This annotated document is effective December 14, 2020. It provides guidance on the development of the Individual Education Program; guidance related to school closures associated with COVID-19; and guidance pertaining to the October 2020 revision to Act 26 questions associated with postsecondary transition.
Age:School Age
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:11/16/2014 11:00:00 PM
NOTICE OF RECOMMENDED EDUCATIONAL PLACEMENT/PRIOR WRITTEN NOTICE (NOREP/PWN) - School Age
Ce formulaire NOREP/PWN offre un format que les LEA peuvent choisir de communiquer aux parents le programme éducatif recommandé pour leur enfant et d'autres mesures prises par l’ LEA. Ce NOREP/PWN révisé comprend des ressources supplémentaires pour les parents à la page 4. Le formulaire révisé contient le pied de page "Octobre 2014." Version annotée disponible.
Age:School Age
Language:French