Forms Related to Special Education and Special Services

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Fairfax County Public Schools (FCPS) individualized education program (IEP) forms have been revised year to incorporate the changes within the Individuals with Disabilities Education Act (IDEA), which was reauthorized in November of 2004. All forms are PDF files acrobat.

The IEP and related forms have been revised and renumbered:

  • IEP 100’s: Static Information Forms related to IEP (Individualized Education Program)
  • IEP 200’s: Forms related to IEP that include data to be completed (notices, etc.)
  • IEP 300’s: IEP Forms
  • ISP 400’s: Forms related to ISPs (Individual Services Plan)
  • IFSP 500’s: Forms related to IFSPs (Individual Family Services Plan)

For more information about the new IEP forms please contact your child's special education teacher or the school principal. Additional information on the IEP process.

IEP Form Number/Title
IEP-102 Parent Information for IEP acrobat
IEP-105 ESY Information Sheet acrobat
IEP-201 IEP Meeting Notification Contact Log acrobat
IEP-202 IEP Notice - Initial/Annual acrobat
IEP-203 IEP Progress Report - Annual Goals acrobat
IEP-204 IEP Progress Report - Annual Goal/Short Term Objectives acrobat
IEP-205 ESY Progress Reporting acrobat
IEP-208 Non-Attendance of IEP Team Members acrobat
IEP-209 Manifestation Determination Review acrobat
IEP-211 IEP Addendum Without a Meeting acrobat
IEP-212 IEP Progress Report - Short Term Objectives acrobat
IEP-213 Parent Notification of Manifestation Determination Review Meeting acrobat
IEP-215 Preschool Transmittal Letter acrobat
IEP-217 AIM-VA Verification Form acrobat
IEP-301 IEP Meeting Agenda acrobat
IEP-302 IEP Cover Page acrobat
IEP-303 Transition Goals acrobat
IEP-304 Transition Services acrobat
IEP-306 Area of Need/Annual Goal and Short Term Objectives acrobat
IEP-307 Area of Need/Annual Goal acrobat
IEP-308 Curriculum/Classroom Accommodations and Modifications acrobat
IEP-309 Information Related to Present Level of Educational Performance acrobat
IEP-310 Elementary Assessment acrobat
IEP-311 Elementary Accommodations acrobat
IEP-312 Middle School Assessment acrobat
IEP-313 Middle School Accommodations acrobat
IEP-314 High School Assessment acrobat
IEP-315 High School Accommodations acrobat
IEP-316 VAAP Criteria acrobat
IEP-317 VGLA Criteria acrobat
IEP-318 VSEP Criteria acrobat
IEP-319 Least Restrictive Environment acrobat
IEP-320 Services acrobat
IEP-321 Placement acrobat
IEP-322 Extended School Year acrobat
IEP-323 Prior Notice and Consent acrobat
IEP-325 Calculator Criteria Form acrobat
IEP-326 Read Aloud or Audio Accommodations Criteria Form acrobat
IEP-327 Behavioral Intervention Plan acrobat
IEP-328 Transfer Student Documentation acrobat
IEP-329 Functional Behavioral Assessment acrobat
IEP-331 Credit Accomodations Eligibility Form acrobat
Procedural Safeguards
Form # Form Name
SS/SE 8 Student Audit Trail acrobat
SS/SE 10 Special Education Eligibility acrobat
SS/SE 4 Virginia Procedural Safeguards acrobat
SS/SE 210 Secondary School Transition Summary acrobat
IEP 212 Progress Report Short Term Objectives acrobat
IFSP and ISP Forms
Form # Form Name
IFSP 501 IFSP Summary Sheet acrobat
ISP 401 ISP Meeting acrobat
ISP 402 ISP Parent Informationacrobat
ISP 403 Individualized Services Plan acrobat
ISP 404 ISP Goals acrobat
ISP 405 ISP Progress Report acrobat
Other Requested DSS Forms
SS/SE 2 Notice and Consent for Evaluation acrobat
SS/SE 79 Consent for Release of Educational Recordsacrobat 
SS/SE 130 Parental Notice of Appealacrobat
SS/SE 280 Consent to Exchange Confidential Student Informationacrobat

Contact Information:

Dawn Schaefer, coordinator
Due Process and Eligibility

Webpage Curator

Keyanna Williams


Last Updated

February 2, 2016