Additional Needs Paraprofessional Support
This form must be completed for any additional Para support request.
Student: *
Teacher: *
What type of support is needed? *
Is there a safety concern for self or others? Please describe. *
Does the student have a behavior plan? *
Does the student require assistance with basic functional skills? *
Please rate these areas for this student on levels of assistance: *
Independent
Supervision
Minimal/Moderate
Significant
Complete
Mobility
Toileting
Feeding
Safety
Behavior
Academic
How many minutes of Para support a day would this student possibly need? *
Have you submitted a Para schedule to your Para Facilitator for SY 20? *
What is your current student/adult ratio in your room? *
If an additional Para is hired what would the Paras schedule be? Include days and start and end times. *
If an additional Para is hired what would be some qualities/skills you would like the Para to possess? *
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