Forms

Oregon Accessibility Manual (OAM) Accessibility Worksheets

The OAM has been completely revised this year. It is in a far more user-friendly format. A new addition to the OAM are individual student worksheets. These may be used to document supports and/or accommodations students will need for testing.  This link will take you to a folder where we have prepared fillable PDF versions of the forms. Feel free to download copies to your drive and use them in your buildings to help facilitate the documentation and transfer of information regarding testing supports. If you have any questions, contact Tom Luba.

ELPA Summative Domain Exemption Form

Use this form to record ELPA domain exemptions per student IEPs or 504 plans. Please note: No 4-domain exemptions are allowed on the ELPA Summative.  A new IEP meeting is needed for students who had domain exemptions in previous years who need to take the ELPA this year. Please collaborate with your school SpEd Case Manager.  

The link below will prompt you to download a copy of the Google document (form) to your Google Drive. Please complete it and share it with Tom Luba (lubat@hsd.k12.or.us) in Technology Services. Wait until you hear back from Tom Luba before assessing the student as an assurance that the exemptions have been entered into the ODE system.

Form Link

Smarter Balanced ELA/Math Opt-Out Forms (for download/print)

OSAS Science and ELPA Summative
Exemption From Testing Forms (for download/print)

SEED Survey Notice and Participation Form

Additional information regarding the SEED Survey may be found on this ODE website.

Potential Test Impropriety Initial Form

School Test Coordinators should use this form to report all known or suspected testing improprieties. This report should be made within 24 hours of the incident. If you have questions, contact Tom Luba, District Test Coordinator. Please note that all potential testing improprieties or irregularities must be reported to the HSD District Test Coordinator using this form. ODE Test Security will not accept reports directly from schools.

Assurance of Test Security Forms (fillable PDFs)

School Test Coordinator

Test Administrator 

Non-Test Administrator

ELPA Screener Domain Exemptions Reminder and Form
(regular screening)

Please remember that you must complete and submit a separate domain exemption form for all students in your building who require domain exemptions on the ELPA Screener. These exemptions DO NOT carry over from one year to the next nor from the ELPA Summative. Domain exemptions must be entered into TIDE by the District Test Coordinator in advance of students taking the ELPA Screener. The link below will prompt you to make a copy of the form on your drive. Please complete the form and share it with Tom Luba (lubat@hsd.k12.or.us) Wait until you hear back from Tom Luba before assessing the student as an assurance that the exemptions have been entered into the ODE system.

Form Link