Boston Public Schools: ChildFind - Family Input/ Developmental History (AGES 6-21)
Child Find requires school districts to identify, locate and evaluate all children with disabilities, regardless of the severity of their disabilities. This obligation to identify all children who may need special education services exists even if the school is not providing special education services to the child. Parents, relatives, public and private agency employees, and concerned citizens are urged to help Boston Public Schools find any child who may have a disability and needs Special Education. 

Who is eligible for a Child Find Screening:
  1. A Boston resident but attends a private or parochial school (non-charter) or is homeschooled  in Boston, and/or
  2. A resident of another district but attends a private or parochial school in Boston

Form in other languages: 
Español | العربية | Cabo-Verdiano | 中文 | Français | Kreyòl Ayisyen | Português | Soomaali | Tiếng Việt


For Child Find screenings for students under the age of 6, please contact the Office of Special Education at 617-635-8599 or by email at childfind@bostonpublicschools.org.
Sign in to Google to save your progress. Learn more
Email *
Child's First Name: *
Child's Last Name: *
Child's date of birth: *
MM
/
DD
/
YYYY
Child's Gender: *
Child's age: (please note, if the child is under 6 years old, you need to email BPS Office of Special Education at childfind@bostonpublicschools.org. This form is only for children ages 6-21). *
List child's primary caregivers and their relationship to the child. *
What are the primary languages used in the home regardless of the language spoken by the student? (Write up to three) *
What is the language most often spoken by the student? (Write only one)
 *
Write the language you understand best and in which you prefer to receive school communication? (Write only one)
 *
Home address: *
Parent phone number(s):   *
Parent email(s): *
Name of child's current school: *
Current grade level: *
Name of school(s) child has formerly attended: *
Does your child have (or ever had) an IEP? If yes, please bring to screening.  *
Has your child ever been: (check all that apply) *
Required
List your child’s academic or other strengths: *
Describe your child’s areas of concern(s): (please be as specific as possible) *
Has your child had any chronic health problems? (e.g. asthma, diabetes, heart conditions), if yes please explain. *
Has your child had any accidents, operations, or severe illnesses? If yes please explain. *
How is your child's: *
Good
Fair
Poor
Hearing
Vision
Additional Information
Appointments are required for screening. Please choose the date you would like to schedule your child's screening. You will receive more information and confirmation of screening date/time via email. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Boston Public Schools.

Does this form look suspicious? Report

Google Forms