Parent Request for Special Education Evaluation
Please complete this form if you are requesting a Full and Individual Evaluation for your student through Special Education.
If you have any questions, contact:
Southeast Texas Cooperative, serving the students of Devers ISD, Hardin ISD, Hull Daisetta ISD, Liberty ISD, Tarkington ISD
Person completing request
Preferred Contact Number
Devers ISD (DISD)
Hardin Elementary School (HISD)
Hardin Middle School (HISD)
Hardin High School (HISD)
Hull Dasietta Elementary School (HDISD)
Hull Dasietta Junior/High School (HDISD)
San Jacinto Elementary (LISD)
Liberty Elementary School (LISD)
Liberty Middle School (LISD)
Liberty High School (LISD)
Tarkington Primary School (TISD)
Tarkington Intermediate School (TISD)
Tarkington Middle School (TISD)
Tarkington High School (TISD)
Homeschool - If so, which campus would the student attend, if enrolled? Please put in other.
Areas of concern
Health (i.e. epilepsy, hemophilia, diabetes, etc.)
Do you have any concerns regarding vision/hearing for your student?
Do you have educational decision making rights for your student?
How do you prefer to receive referral documents?
Is your student currently in special education (including speech impairment)?
Please let us know any additional information that you would like to share and/or is applicable to your student.
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This form was created inside of Liberty ISD.