Special Education and Pupil Personnel

B.	Child Study
	Authorization for Release/Exchange of Record Information	P29	P29
	CS Follow-up Meeting	PP-715	PP-715
	CS Initial Meeting	PP-714	PP-714
	CS Parent Notification	PP-711	PP-711
	CS Referral Team Referral Form	PP-710	PP-710
	CS Teacher Letter and Input	PP-712	PP-712
	Parental Consent for Billing Insurance	PP-745	PP-745
	Prior Notice and Consent for Evaluation	PP-716	PP-716
	Prior Written Notice	PP-775	PP-775
	Timeline Tracking Log	PP-717	PP-717

C.	504
	504 Procedural Safeguards	PP-801	PP-801
	504 Prior Written Notice	PP-802	PP-802
	504 Report of Findings	PP-803	PP-803
	Authorization for Release/Exchange of Record Information	P29	P29
	Parent Notification of 504 Meeting	PP-800	PP-800
	Parent Notification of Eligibility Meeting	PP-723	PP-723
	Prior Notice and Consent for Evaluation	PP-716	PP-716
	Section 504 Eligibility Summary	PP-804	PP-804

D.	Eligibility
	Autism Criteria	PP-739	PP-739
	Class Observation	PP-720	PP-720
	Deaf Blindness Criteria	PP-726	PP-726
	Developmental Delay Criteria	PP-727	PP-727
	Educational Narrative	PP-721	PP-721
	Eligibility Addendum for Termination of Services	PP-725	PP-725
	Eligibility Summary	PP-719	PP-719
	Emotional Disturbance Criteria	PP-728	PP-728
	Exit Criteria for Speech/Language Services	PP-744	PP-744
	Hearing Impairment/Deafness Criteria	PP-729	PP-729
	Learning Disability Criteria	PP-730	PP-730
	Medical Evaluation	PP-722	PP-722
	Mental Retardation Criteria	PP-732	PP-732
	Multiple Disabilities Criteria	PP-731	PP-731
	Orthopedic Impairment Criteria	PP-733	PP-733
	Other Health Impairment Criteria	PP-738	PP-738
	Parent Notification of Eligibility Findings	PP-724	PP-724
	Parent Notification of Eligibility Meeting	PP-723	PP-723
	Prior Written Notice	PP-775	PP-775
	Regressed Scores	PP-787	PP-787
	Severe Disabilities Criteria	PP-734	PP-734
	Speech/Language Impairment Criteria	PP-737	PP-737
	Timeline Tracking Log	PP-717	PP-717
	Traumatic Brain Injury Criteria	PP-735	PP-735
	Vision Impairment Criteria	PP-736	PP-736
	We Stand Ready Letter	PP-743	PP-743
E.	Homebound/Homebased
	Authorization for Release/Exchange of Record Information	P29	P29
	HB Tracking Sheet	PP-705	PP-705
	Instruction Service Agreement	PP-702	PP-702
	Medical Certification	PP-704	PP-704
	Parental Agreement for HB Instruction	PP-701	PP-701
	Prior Written Notice	PP-775	PP-775
	Service Referral and Projected Plan	PP-700	PP-700
	Teacher Agreement	PP-703	PP-703
	Time Sheet	B28	B28
	Mileage Reimbursement	B35

F.	Miscellaneous
	60 Day Screening Log	PP-780	PP-780
	Application for Autism Program	PP-777	PP-777
	Application for Life Skills Program	PP-778	PP-778
	Career Assessment	PP-781	PP-781
	Equipment Inspect Log	PP-783	PP-783
	ESY Eligibility Worksheet	PP-790	PP-790
	Funding Request for Professional Development	PP-784	PP-784
	IEP Transfer Request form	PP-805	PP-805
	Parental Consent for Billing Insurance	PP-745	PP-745
	Permission to Transport	PP-785	PP-785
	Prior Written Notice	PP-775	PP-775
	Referral to ESAP	PP-791	PP-791
	Referral to School Social Worker	PP-789	PP-789
	Therapy Student Record	PP-788	PP-788
	Positive Behavioral Support Center - procedure	.pdf	.doc
	Positive Behavioral Support Center - referral	.pdf	.doc
	Consent to Bill	PP-745	PP-745

G.	Re-Evaluation/Triennial
	Authorization for Release/Exchange of Record Information	P29	P29
	Component Selection: Re-evaluation	PP-740	PP-740
	Eligibility Addendum for Termination of Services	PP-725	PP-725
	Eligibility Summary	PP-719	PP-719
	Exit Criteria for Speech/Language Services	PP-744	PP-744
	Parent Notification of Eligibility Findings	PP-724	PP-724
	Parent Notification of Eligibility Meeting	PP-723	PP-723
	Parental Consent for Billing Insurance	PP-745	PP-745
	Parental Notification of Intent for Re-evaluation	PP-742	PP-742
	Prior Written Notice	PP-775	PP-775
	Timeline Tracking Log	PP-717	PP-717
	We Stand Ready Letter	PP-743	PP-743
	Consent to Bill	PP-745	PP-745

H.	Related Services
	Communication Disorders Initial Screening	PP-763	PP-763
	Developmental Sequence of Phonemes	PP-756	PP-756
	Eligibility Addendum for Termination of Services	PP-725	PP-725
	Exit Criteria for Speech/Language Services	PP-744	PP-744
	Hearing Referral Letter	PP-764	PP-764
	Kindergarten Screening Letter	PP-786	PP-786
	Medicaid Parental Consent	MED- 5	MED- 5
	Occupational Therapy Referral	PP-766	PP-766
	Order for Therapy Evaluation	MED- 6	MED- 6
	OT Therapy Notes	MED- 9 OT	MED- 9 OT
	Physical Therapy Referral	PP-767	PP-767
	Plan of Care	MED- 8	MED- 8
	Plan of Care Addendum	MED- 12	MED- 12
	Plan of Care Discharge	MED- 13	MED- 13
	PT Therapy Notes	MED- 9 PT	MED- 9 PT
	SLP Therapy Notes	MED- 9 SLP	MED- 9 SLP
	Speech/Language and Voice Screening	PP-765	PP-765
	Therapy Student Record	PP-788	PP-788

I.	Discipline
	Authorization for Release/Exchange of Record Information	P29	P29
	Behavior Intervention Plan	PP-770	PP-770
	Determination of Services During Suspension	PP-768	PP-768
	Functional Behavior Assessment	PP-771	PP-771
	Manifestation	PP-772	PP-772
	Prior Written Notice	PP-775	PP-775
	Short Term Suspension	PP-773	PP-773
	Tracking of Suspension	PP-774	PP-774
	Checklist of Pattern	PP-769	PP-769

K.	Preschool
	Developmental Sequence of Phonemes	PP-756	PP-756
	Early Childhood Social and Developmental History	PP-754	PP-754
	Preschool Outcome Summary		PP-753
	Preschool Referral	PP-755	PP-755*
	Preschool Child Study	PP-757	PP-757

L.	Surrogate Parent
	Application for Surrogate Parent	PP-706	PP-706
	Appointment of Surrogate Parent	PP-708	PP-708
	Referral for Surrogate Parent	PP-707	PP-707
	Review of Surrogate Parent	PP-709	PP-709

M.	Assistive Technology
	Augmentative and Alternative Communication Guidance Document for RCPS	.pdf	.doc
	Assistive Technology Home Checkout	PP-761	PP-761
	Assistive Technology Transfer Form	PP-762	PP-762
	Assistive Technology Consideration Form	PP-760	PP-760
	Assistive Technology Request Form	PP-758	PP-758

* - form is compatible with Word 2007 and later.

Special Education and Pupil Personnel

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