Central Rivers AEA Guidance for Special Education Forms
Check/Yellow = Required Eligibility Determination Worksheet (EDW)Initial Evaluation ReevaluationReview AmendmentsTransition from Early Access IFSP to Early Childhood IEPTransition from Early Childhood IEP (Spring) to Kindergarten IEP (Fall)Adding a Goal Area/ Support Services to Existing IEP Discontinue a Goal Area/ Support Service45 Day Trial Out of Goal Area or All Special Education ServicesStudent Move In from Out of State
Forms Disability Suspect
Visual Display of Progress Data (Print or Attached in Associated Files)
Consent for Evaluation
Consent for/Notice of Reevaluation (Signature required if collecting new data)
Reevaluation (R) Page (if exiting all services)
Education Evaluation Report (EER)
Eligibility Determination Worksheet (EDW)
Consent for Initial Special Education and/or Related ServicesIf Eligible
Consent to Receive Electronic CommunicationIf Needed If Needed
Early Childhood Outcomes SummaryThis form is required for students ages 3‐5 and must be completed at initial IEP meetings, annual review, re‐evaluation, exit meetings, and upon transition from ECSE to kindergarten. This form is required for ages 3 through 5 (ECO not required for initial evaluations of 5-year old Kindergartens.
Early Childhood Worksheet
(F Page)
*Move future services to services tab with Amendment (F page)
Prior Written Notice of Proposed or Refused Action
Meeting Notice (signed by attendees, uploaded to Associated Files)With MeetingSpring
If with a Meeting
If with a Meeting
Agreement to ExcuseAn IEP Team member is not required to attend an IEP meeting if that member’s area of curriculum or service is not being modified or discussed, and the parent and the area education agency or school agree. Notice should be given to the parent(s) prior to the meeting.
Procedural Safeguards Manual for ParentsMust be given to parents once per school year as well as: *upon initial referral or parent request for evaluation; *upon receipt of the first state complaint in a school year; *upon receipt of the first due process complaint in a school year;
*in accordance with discipline procedures. *A summary of the procedural safeguards may be used to assist in explaining and reviewing parental rights, but must not be used in place of a full copy of the complete procedural safeguards.
Exchange of Information FormMust be completed when seeking information from an outside agency
Extended School Year Services Form Must be completed for students determined eligible for Extended School Year Services
Special School Placement IEP team decision if a student will attend a special school and Special School form must be completed
Manifestation Determination LEA team competes when an eligible individual meets or exceeds ten school suspensions. Refer to p. 209 in the Documentation Guide for suspension guidelines.
Functional Behavioral Assessment Complete an FBA when behaviors impede student learning and requiring support within our outside the general education classroom including following concerns social emotional, behavior, mental health. *New FBA needed if the current function of behavior is in question.
Behavior Intervention Plan Complete a BIP if FBA determines a BIP is needed. Reviewed at every annual IEP meeting. New BIP for every Reevaluation.
Medicaid Consent/Refusal (LEA/AEA)This form should be signed by the parent or guardian of a Medicaid eligible individual for whom the district (LEA) or AEA files claims for services. The form is a ONE TIME signature. A new LEA and/or AEA form will need to be completed if the student moves to a different LEA and/or AEA. AEA signed forms must be sent to Central Files.
Summary for Post Secondary Living, Learning, and Working Upon exiting for graduation
School Accommodation Report (SAR) Complete for graduates intending to attend college