Pre-Referral Process

The pre-referral process should be utilized when a student is experiencing academic failure in a course that is not attributable to lack of attendance.

In addition to reviewing the steps listed below, please review the 3 documents on the right.

1. List of all in-class interventions attempted prior to referral.

Note: Student Support Services and the Special Education Lead Teacher will provide support. In-class interventions for general education students are the responsibility of general education teachers.

2. Contact parent to discuss student difficulties and proposed interventions.

          • Use the Parent Communication Log (found under the Teacher Info/Forms tab of the curriculum website) to document communication.

3. Attendance record of student; student start date in your class to the present.

4. Contact Dr. Williams at jawilliams@dohnschool.org.

*Please remember, poor attendance is not a basis for referral.



If a parent requests an evaluation for special education and or related services, you must:

  • Pick up a consent form from the Student Support Services office.
  • Provide documentation of all contact with parents, including dates, times and the method of request (i.e., in writing, phone call or in person).
  • Provide parent contact information.
Pre-Referral Interventions Record.pdf
In-Class Interventions Suggestions.pdf
Pre-Referral Process 2017-2018.pdf

Please contact Student Support Services to complete the State form Referral for Evaluation ( PR-04)