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 241-250 of 318
Request for Consent for a Reevaluation cover image

Request for Consent 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
Request for Consent for a Reevaluation (ANNOTATED) cover image

Request for Consent 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
RESUMEN DE LOS LOGROS ACADÉMICOS Y EL DESEMPEÑO FUNCIONAL - Edad escolar  cover image

RESUMEN DE LOS LOGROS ACADÉMICOS Y EL DESEMPEÑO FUNCIONAL - Edad escolar

Effective Date:6/30/2008 11:00:00 PM
SUMMARY OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE - School Age Este formulario entrará en vigor el 1° de julio de 2008. Este Resumen de Logros Académicos y Desempeño Funcional (con un pie de página que indica “Revisiones de julio de 2008”) sustituye al Resumen de Desempeño del Alumno actual. Versión con acotaciones disponible
Age:School Age
Language:Spanish
RIASSUNTO DELLO SVOLGIMENTO E DEL RENDIMENTO FUNZIONALE - ETÀ SCOLARE cover image

RIASSUNTO DELLO SVOLGIMENTO E DEL RENDIMENTO FUNZIONALE - ETÀ SCOLARE

Effective Date:6/30/2008 11:00:00 PM
SUMMARY OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE - School Age Questo modulo entra in vigore a partire dal 1 ° luglio 2008. Questa Sintesi dello Svolgimento Accademico e del Rendimento Funzionale rivisto (con un piè di pagina che indica "Revisioni Luglio 2008") sostituisce l'attuale Riepilogo del Rendimento degli Studenti. Disponibile la Versione annotata.
Age:School Age
Language:Italian
Parental Consent to Excuse Members from Attending the Individualized Education Program (IEP) Team Meeting (Croatian) cover image

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

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:Croatian
Service Coordination Checklist for Providing Information to Families about Medical Assistance cover image

Service Coordination Checklist for Providing Information to Families about Medical Assistance

Effective Date:9/14/2020 7:25:55 AM
This document provides guidance to Infant Toddler Early Intervention Service Coordinators on discussing enrollment in Pennsylvania’s Medical Assistance program with families.
Age:Infant/Toddler
Language:English
Special Education State Complaint Resolution Procedures cover image

Special Education State Complaint Resolution Procedures

Effective Date:2/29/2016 11:00:00 PM
This publication outlines the procedures that are followed when complainants allege that the rights of one or more students eligible for services under the IDEA, Chapters 14 or 711 in the State Board Regulations or corresponding federal statutes or regulations have been violated. The IDEA requires the Bureau of Special Education (BSE) to encourage local and less adversarial resolutions to issues. However, federal regulations are clear that resolution activities cannot bar the complaint investigation process. The purpose of these procedures is to: 1. Clearly articulate the process to be followed. 2. Serve as a reference guide and training document. 3. Ensure compliance with federal and state guidelines.
Age:School Age
Language:English
Special Education State Complaint Resolution Procedures cover image

Special Education State Complaint Resolution Procedures

Effective Date:2/29/2016 11:00:00 PM
This publication outlines the procedures that are followed when complainants allege that the rights of one or more students eligible for services under the IDEA, Chapters 14 or 711 in the State Board Regulations or corresponding federal statutes or regulations have been violated. The IDEA requires the Bureau of Special Education (BSE) to encourage local and less adversarial resolutions to issues. However, federal regulations are clear that resolution activities cannot bar the complaint investigation process. The purpose of these procedures is to: 1. Clearly articulate the process to be followed. 2. Serve as a reference guide and training document. 3. Ensure compliance with federal and state guidelines.
Age:School Age
Language:Chinese
Special Education State Complaint Resolution Procedures cover image

Special Education State Complaint Resolution Procedures

Effective Date:2/29/2016 11:00:00 PM
This publication outlines the procedures that are followed when complainants allege that the rights of one or more students eligible for services under the IDEA, Chapters 14 or 711 in the State Board Regulations or corresponding federal statutes or regulations have been violated. The IDEA requires the Bureau of Special Education (BSE) to encourage local and less adversarial resolutions to issues. However, federal regulations are clear that resolution activities cannot bar the complaint investigation process. The purpose of these procedures is to: 1. Clearly articulate the process to be followed. 2. Serve as a reference guide and training document. 3. Ensure compliance with federal and state guidelines.
Age:School Age
Language:Spanish
Agreement to Waive Reevaluation (Croatian) cover image

Agreement to Waive Reevaluation (Croatian)

Effective Date:7/1/2008 12:00:00 AM
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:Croatian