Mask Mandate Students with Disabilities Complaint Survey
Many parents are experiencing difficulty and/or denial when requesting exemptions or alternatives to masks for their students with disabilities. Under IDEA, Section 504, and ADA students with disabilities have rights to Free Appropriate Public Education (FAPE) in the most Least Restrictive Environment (LRE). Governor Edward’s mask mandate provides for two (2) exemptions that apply to these demographics of students. Many students with disabilities also have an Individualized Health Plan (IHP).

If you are experiencing difficulties related to the mask mandate, preventing your student from receiving FAPE under this order or a school systems more strict policy, and feel it is a violation against your students rights under IDEA, Section 504 or ADA, and have an IEP, 504 Plan or are in the process of being evaluated by pupil appraisal, and would like to receive assistance, complete this form. **If you would like to be contacted please provide your name and email
Sign in to Google to save your progress. Learn more
Parent Name (OPTIONAL only if you want to be contacted)
Email Address (OPTIONAL only if you want to be contacted)
Name of School District *
Does your child have an IEP or 504 Plan? (Select one) *
List all Disabilities/Deficits/Exceptionalities (ex: ADHD, autism, speech delay, etc) *
Does your student with disabilities have any aversions or difficulties with wearing a mask? *
Is the school system denying your request to waive the mask requirement? (*this is NOT related to any philosophical or other type of exemption request.*) *
Does your student have a communication disorder or a suspected communication disorder? *
Does your student have an Individualized Health Plan (IHP)? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report