Assessment Data

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Evaluation Start Date

The IIEP assessment report will not be used by psychologists, OT/PT, speech, or CAT. Instead, a separate evaluation report will be completed and uploaded.

M Team Members

Reason for Referral

Add Assessments

Synthesized Summary

Put your summary of testing here, along with your recommendations. You must enter at least 200 characters for overall summary. Cut and paste from your Word document.

For SLD evaluations, indicate areas of processing deficits and relationship to academic difficulties. SLD checklist will also need to be uploaded or faxed in.
For ED evaluations, indicate the criteria that the student may meet; or that the student does not appear to meet any. ED checklist will also need to be uploaded or faxed in.
For ASD evaluations, indicate the criteria which the student appears to meet. The ASD checklist will also need to be uploaded or faxed in.

At the end of the report, list: M-team members for this evaluation. And at the end, Report submitted by....... (also list credentials and License #)