Forms Related to Special Education

Forms related to the Individualized Education Program (IEP)

Multipurpose Referral Forms

Procedural Safeguards

  • se4

    Virginia Special Education Procedural Safeguard Requirements

Basis for Committee Decision (BCD) Forms

  • se10a

    ss/se-10a Autism Basis for Committee Decision

  • se10b

    ss/se-10b Emotional Disability Basis for Committee Decision

  • se10c

    ss/se-10c Hearing Impairment Basis for Committee Decision

  • se10d

    ss/se-10d Intellectual Disability Basis for Committee Decision

  • se10e

    ss/se-10e Multiple Disabilities Basis for Committee Decision

  • se10f

    ss/se-10f Orthopedic Impairment Basis for Committee Decision

  • se10g

    ss/se-10g Other Health Impairment Basis for Committee Decision

  • se10i

    ss/se-10i Specific Learning Disability Basis for Committee Decision

  • se10j

    ss/se-10j Speech/Language Impairment Basis for Committee Decision

  • se10k

    ss/se-10k Traumatic Brain Injury Basis for Committee Decision

  • se10l

    ss/se-10l Visual Impairment Basis for Committee Decision

  • se10m

    ss/se-10m Developmental Delay Basis for Committee Decision

  • se10n

    ss/se-10n Deafness Basis for Committee Decision

  • se10p

    ss/se-10p Deaf-Blindness Basis for Committee Decision

Individualized Education Program (IEP) Forms

  • iep101

    IEP Meeting Agenda for Parents

  • iep102

    IEP-102 Parent Information IEP

  • iep105

    Extended School Year Services

  • iep201

    IEP Meeting Notification Contact Log

  • iep202

    IEP Notice - Initial/Annual

  • iep203

    IEP Progress Report - Annual Goals

  • iep204

    IEP Progress Report - Annual Goal/Short Term Objectives

  • iep205

    ESY Progress Reporting

  • iep208

    Non-Attendance of IEP Team Members

  • iep209_draft

    Draft form IEP-209 MANIFESTATION DETERMINATION REVIEW

  • iep211

    IEP Addendum Without a Meeting

  • iep212

    IEP Progress Report - Short Term Objectives

  • iep215

    Preschool Transmittal Letter

  • iep301

    IEP Meeting Agenda

  • iep302

    IEP Cover Page

  • iep303

    Transition Goals

  • iep304

    Transition Services

  • iep306

    Area of Need/Annual Goal and Short Term Objectives

  • iep307

    Area of Need/Annual Goal

  • iep308

    Curriculum/Classroom Accommodations and Modifications

  • iep309

    Information Related to Present Level of Educational Performance

  • iep310

    Elementary Assessment

  • iep311

    Elementary Accommodations

  • iep312

    Middle School Assessment

  • iep313

    Middle School Accommodations

  • iep314

    High School Assessment

  • iep315

    High School Accommodations

  • iep316

    VAAP Criteria

  • iep317

    VGLA Criteria

  • iep318

    VSEP Criteria

  • iep319

    Least Restrictive Environment (LRE)

  • iep320

    Services

  • iep321

    Placement

  • iep322

    Extended School Year

  • iep323

    Prior Notice and Consent

  • iep325

    Calculator Criteria Form

  • iep326

    Read Aloud and Audio Accommodation Criteria Form

  • iep327_draft

    Draft form IEP-327 Behavior Intervention Plan

  • iep327a_draft

    Draft form IEP-327a Behavior Intervention Plan Review

  • iep328

    Transfer Student Documentation

  • iep329_draft

    Draft form IEP-329 Functional Behavior Assessment

  • iep331

    Credit Accommodations Eligibility Form

Individual Services Plan (ISP)

  • isp401

    Individual Services Plan Meeting Notification

  • isp402

    Parent Information Regarding Children with Disabilities Enrolled by Their Parents in Private

  • isp403

    Individual Services Plan

  • isp404

    ISP Goals

  • isp405

    ISP Progress Report

Additional Forms

  • se79

    Release of Student Records Authorization

  • se79a

    CONSENT TO EXCHANGE CONFIDENTIAL STUDENT INFORMATION

  • se127

    SS/SE-127 Parent Information

  • se130

    Notice of Appeal

  • se215

    Request for Wavier of Full-Day Schedule Requirement

  • se217_draft

    Draft form SS/SE-217 Functional Behavior Assessment

  • se218_draft

    Draft form SS/SE-218 Behavior Intervention Plan

  • se218a_draft

    Draft form SS/SE-218a Behavior Intervention Plan Review

  • se329

    Identification of Military Connected Students

  • SS/SE-338 Certification of the Inability to Provide Consent

    Certification of the Inability of a Student to Provide Informed Consent for Educational Decisions Made Under the Individuals with Disabilities Education Act (IDEA)

  • se340

    Specific Power Of Attorney for Educational Decisions Made Under the Individuals with Disabilities Education Act (IDEA)

  • SE348

    SS/SE348 Special Permission Locally Awarded
    Verified Credit Accommodation (SPLAVC-A) Criteria Form