AT PAUSD Request for Collaboration (RFC)

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This form is for PAUSD staff only. If you are a not PAUSD staff please contact your student's case manager and ask them to fill out this form.

Email *

Your school site *

What prompted you to make a request for collaboration with the PATCH team? *

Teacher request

Parent request

Counselor request

Advocate request

Administrator suggestion

Mediation or due process agreement

Conversation with an AT Team member

Required

Primary area of academic concern? *

Please check all that apply

Writing

Reading

Executive Functioning

Math

Physical Access

Other:

Required

Type of Request *

Student's first name, last initial (ex: Brian G)

If you have selected "Class Training" please leave the field below blank

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