DIBELS Benchmark Invalidation Request Form
BEFORE invalidating any benchmark assessment in DIBELS, complete this form for the Benchmark invalidation that you are requesting to complete on EACH student. DO NOT Reset UNTIL, you get an email confirming that it has been approved.
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Email *
Teacher Name *
Student Name *
Date assessment measure was completed. *
MM
/
DD
/
YYYY
Student PowerSchool Number *
School *
Time of Year *
I am requesting to invalidate the following DIBELS Measure. *
I am requesting to invalidate the DIBELS assessment measure because... (Explain why you need to invalidate.) Invalidations will only be approved in extenuating circumstances such as fire drill, lock down, sick student, etc. *
I understand that I may NOT invalidate a measure until I get an email confirming that I should do so. *
Any other notes or comments? *
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