Section 504: Forms, Related Documents, and Resources
Titles of forms and documents related to Section 504. Includes Section 504 Procedural Safeguards and the Section 504 Procedures Manual.
Forms documenting the referral, evaluation, initial qualification, reevaluation, 504 Plan, and any causality hearings for a student considered for and/or qualified with a disability under Section 504 should be maintained in the student’s scholastic record.
Used to communicate Section 504 Procedural Safeguards for parents.
Parents are provided a copy of the 504 procedural safeguards notice prior to evaluation, Child Find, identification, reevaluation, and/or placement.
Used by FCPS staff to notify parents of an upcoming 504 meeting.
This notice is sent to parents prior to their child’s 504 Initial Qualification, 504 Plan, or 504 Reevaluation meeting.
Used by parents to give FCPS schools authorization to share confidential information.
Used by special education staff to determine whether to do a 504 plan.
Used to identify that an FCPS student has qualified for an accommodation under Section 504.
The 504 Plan form is completed by the knowledgeable committee during a student’s 504 plan meeting. Accommodations, modifications, and/or services necessary to afford the student the equal opportunity to access school programs and activities are addressed with the 504 plan document.
Used by 504 staff to provide prior written notice to parents.
Used to document services needed for an FCPS student under a 504 accommodation.
Used to identify IEP or 504 Plan Accommodations at the elementary school level.
Used to identify IEP or 504 plan accommodations at the middle school level.
Used to identify IEP or 504 plan accommodations at the high school level.
Used by staff to request a calculator accommodation for a student.
Used by special education staff to list Read Aloud or Audio Accommodation criteria.
Used by special education staff to request special permission for a locally awarded verified credit.
For more information on Section 504 forms or related documents please contact the Section 504 School Based Coordinator (SBC) at your school.
- 504 Plan Calculator Criteria Form (SS/SE-272)
- 504 Plan Meeting Agenda (SS/SE-339)
- 504 Plan Read Aloud or Audio Accommodation Form (SS/SE-274)
- 504 Plan (Testing) Accommodations:
- Elementary Accommodations (SS/SE-86A)
- Middle School Accommodations (SS/SE-86B)
- High School Accommodations (SS/SE-86D)
- Consent to Exchange Confidential Student Information (SS/SE-79A)
- Credit Accommodation Eligibility Form (SS/SE-353)
- Local Screening Committee Report (SS/SE-14)
- Multipurpose Referral (SS/SE-5, 5A)
- Notice of Local Screening Meeting (SS/SE-83)
- Notice Not to Evaluate (SS/SE-13)
- Parent Information (SS/SE-127)
- Parent Notice of Section 504 Causality Hearing (SS/SE-220A)
- Section 504 Causality Hearing (SS/SE-220)
- Section 504: Parent Consent for Individualized Assessment (SS/SE-86G)
- Section 504 Plan Credit Accommodations Eligibility Form (SS/SE-86H)
- Section 504 Qualification (SS/SE-85)
- Section 504 Transfer Student Documentation (SS/SE-86T)
- Special Permission Locally Awarded Verified Credit Accommodation (SPLAVC-A) Criteria Form (SS/SE-348)
- Student Audit Trail (SS/SE-8)
- Student Observation (SS/SE-23)
- Teacher Narrative (SS/SE-22)
- Virginia Special Education Procedural Safeguards Requirement (SS/SE-4)
If a student transfers to another school within FCPS, the file is to be forwarded to the new school in accordance with regulations.
The student’s parent or guardian may examine his or her child’s educational record upon request (see Management of the Student Scholastic Record manual).
Additional Resources
- The Section 504 Regulations (34 C.F.R. Part 104)
- United States Department of Justice Civil Rights Division: Information and Technical Assistance on the Americans with Disabilities Act
- United States Department of Education: Frequently Asked Questions About Section 504 and the Education of Children with Disabilities
- Parent Resource Center workshop on February 9, 2018 - Section 504: What Parents Need to Know
- Parent and Educator Resource Guide to Section 504 in Public Elementary and Secondary Schools
The information available throughout the Section 504 Information website is included in this PDF.
The Special Education Process
Learn how the special education process works and view our Special Education Handbook for Parents.
Special Education Procedural Support
Responsive, student-centered, collaborative guidance and leadership related to the implementation of and compliance with federal, state, and local regulations as they pertain to special education.