Forms

Special Education Rules

June 2023

Working with District Supports

(Least Restrictive Environment)

IEP Procedures Manual

2024

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• ASSESSMENT

  • Assessment-Matrix-2021

  • Assessment Matrix Grid 2021

  • How to Use Matrix 2021

  • Bell Curve - Evaluation Profile Sheet

  • Testing-Materials-Request-Form revAUG2022

  • Explanation of the RPI- WJIV

  • Developmental Curves WJIV

  • CALP Implication Levels-WJIV

• AUDIOLOGY

  • Audiology Page

• AUDITS (FILE REVIEWS)

  • School Audit Schedule 2023/2024

  • File Review Expectations

  • Full Audit Form 2024

  • Transition Audit Form

• Classifications

  • Eligibility classifications/information
    and resources page

• BEHAVIOR

  • Behavior Team Website 

  • Emergency Safety Interventions

• CRITICAL NEEDS REQUESTS

  • Consult Teacher Specialist

• Deaf and Hard of Hearing Services

  • Website Link

• DISCIPLINE

  • IDEA Discipline Flowchart

  • Common Errors

  • Manifestation Determination 2023

  • Manifestation Determinations - Key Points

  • SpEd & Discipline Forum

• DYSLEXIA

  • Dyslexia FAQs 2019

• DYNAMIC LEARNING MAPS (DLM)
  
  

  • Alternate Assessments Participation Guidelines

  • DLM EE/Linkage Level Tracking Sheet

  • DLM Website Resources

  • Math Blueprint

  • ELA Blueprint

  • Science Blueprint

  • EE Elements and Currently Tested Standards

  • Testing Administration Manual

• EXTENDED SCHOOL YEAR (ESY)
  
  

  • ESY FAQ & Documentation PD SLIDES 2024

  • ESY Memo Qualify Jan 2024

  • ESY Eligibility Facts, Tips and Documentation v24

  • JSD ESY Student Data Forms (v24)

  • JSD ESY Summer Contact PRESCHOOL version (ver2024)

  • ESY Employee 2024

• FILES

  • PAAL 2023-24

  • File Checklist 2024

  • Transfer of Files

• GRADUATION

  • Exit Summary Form

    • Embrace form "Summary of Academic Achievement and Functional Performance"

  • Prior Notice Regarding Graduation and Program Termination

    • Embrace form: "Change of Placement"

  • Secondary Math Opt-Out Form
       

• Guidance SLO's

  • Guidance-Behavior-SLO-social skills

  • Guidance-Behavior-SLO-Following Rules

  • Guidance-Behavior-SLO-Engagement

  • Guidance-Behavior-SLO-Compliance

  • Guidance Only-SLO-Relationships

  • Guidance Only-SLO-Emotional Regulation

  • Guidance Only-SLO-Depression-anxiety

• HOME INSTRUCTION

  • Home Instruction
    Contact Teacher Specialist

• IEP

  • Amendments to IEP Guidance (2021)

  • Elementary IEP Goal/Core Alignment

  • Behavior/Social Skill Secondary IEP Goal/Core Alignment

  • Elementary- IEP Checklist

  • Secondary IEP/Re-evaluation Checklist (2024)

  • IEP Meeting Notes 2024

  • PLAAFP TA Document (USBE)

  • PLAAFP and Goal Example

  • Program Modifications & Supports (As Needed) Form

  • Program Modifications & Supports (As Needed) Examples

  • Transfer Students (USBE SER)

• Interpreting and Translation

  • Language Translation:

    • mirsa.joosten@jordandistrict.org 

  • ASL Interpreter

    • Request Interpreter

• JPAS

  • Jordan Evaluation Systems Link

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• LRE
  
  

  • LRE Process Flowchart 

• MATERIALS

  • Materials/Forms Request

• MEDICAID CONSENT
  
  

  • Medicaid Accountability

  • Medicaid Letter, Consent Form, and FAQs

  • Medicaid Letter, Consent Form, and FAQs in Spanish

• MEDICAL

  • Authorization for Release and Use of Health Information (Use Form in Embrace)

  • Medical History Clarification 2024

  • Prior Medical History Form 2024

  • Seizure Log

• MEMOS/NEWSLETTERS

  • 2023-2024 Memos/Newsletters

• MENTOR INFORMATION

  • Mentor Contract 2023 *must be signed every school year*

  • JPAS Information for Provisional Educators

    • Special Education Mentor Checklist and Logs
      These logs and checklists can be used for all provisional educators in all Special Education assignments (including SLP, Psych, Preschool, etc.)
      
      

      • Aug_Sep SPED Mentor logs

      • Oct_Nov_Dec Sped Mentor logs
        
        

      • Jan_Feb SPED Mentor logs

      • Mar_Apr SPED Mentor logs

      • May_June SPED Mentor logs
        
        

    • Speech/Language Pathologists

      • ASHA Rules for Mentors/Mentees

    • School Psychologist

      • NASP Mentorship Program

      • JPAS Domains

• OBSERVATIONS

  • Outside Therapy-Observer Form

  • Response-Discrepancy Observation(Guidance)

  • SLD-observation-form

• POST-SECONDARY TRANSITION

  • Checklist for Transition

  • Consent for Agency Invitation to Transition Meeting (In Embrace)

  • Transition Audit Form Indicator 13

  • Transition Services Examples

  • USBE-School to Post-school Transition

  • Transition Assessments Padlet

• PROCEDURAL SAFEGUARDS & ANNUAL PARENT/GUARDIAN NOTICES
  
  

  • Procedural Safeguards Notice

  • Procedural Safeguards Tip Sheet English

  • Procedural Safeguards Spanish

• PROFESSIONAL DEVELOPMENT

  • Conference Guidelines and Request Form

• REFERRALS

  • Pre-Referral-SPED-flow-Chart

  • Student Level of Performance Jan2023

  • RTI-Tracking-Tool-Fillable-2023

  • RTI Website

  • Using ChartDog to Graph RTI Data

  • Referrals for Support Services
    
    

    • Autism Assessment Referral

    • Documenting OT_PT Consultation in Embrace

    • Language and Culture Services (LCS)

    • LCS Re-Evaluation Request for Limited English Proficient Student

    • OT Referral

    • PT Referral

    • Visually Impaired Referral 

  • Secondary

    • VHS Referral

• REVOCATION OF CONSENT
  
  

  • Revocation of Consent for Receipt of Special Education and Related Services
    Contact Teacher Specialist

•  SCRAM

  • IEP SCRAM Services Form (Revised November 2014)

  • SCRAM 102 (updated 8.19.15)

  • Top Tips for SCRAM

  • READING THE SCRAM REPORT

  • Reading the SCRAM Report (2 of 2)

  • School Weekly Minutes Revised July 2019

  • SCRAM Health Services and Regular Percent (Revised 2017)

• SPECIFIC LEARNING DISABILITY FORMS

  • Elementary-Lines-of-Evidence-Fillable

  • Student Level of Performance 2023

  • 3rd Line of Evidence Examples 

  • Secondary-Lines-of-Evidence-Fillable

• SPEECH-LANGUAGE

  • SLP Forms and Information Page

• TBI

  • TBI Page

•  TRANSPORTATION

  • Sibling rider form (Admin only form)

  • Transportation Behavior Form 2021

  • Transportation Request 2021

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