IEP Forms, Learning Connection, and IEP Manual

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Online IEP Manual

IEP Forms

Forms are currently available in .pdf format. If you do not have the free Adobe PDF Reader, you can download it here: Adobe Make sure you download the correct version for your operating system.

If the link below has a * behind it, you will be able to type directly into the form on your computer. You can then save it, or even upload it into iStart. More forms will be converted as time allows. If you are typing into the form, make sure you use Adobe Reader, and not Preview. Preview will let you type into the form, and save your work, but not reopen it for further editing.

NOTE: 8/18/12 All forms have been revised and will need to be re-formatted so you can type into them. * will be added as they are completed.

If you would like to view a video tutorial with instructions how to open the form in Adobe Reader, click here.

Some forms may be listed more than once if they fit under multiple categories to make them easier to locate.

SBSC link for example of this page

Description Description

IEP Conference Forms

Notice of Case Conference

Notice of Implementation

Billing for Medicaid

Procedural Safeguards – English

Procedural Safeguards – Spanish

Procedural Safeguards (Spanish)

CC Notes and Sign-in Sheet (MS Word Format)

Blank Non Transition IEP (for students not yet 14)*

Blank Transition IEP (for students 14 and older)

Transportation (New! Online form)

Evacuation Plan

Health Plan

ESY Worksheet

Consent to Excuse Participant

IEP Appointment Log

IEP Review Checklist

Record of Attempts to Arrange a Conference

Certificate Track

Certificate of Completion Graduation Requirements

Course of Study Worksheet*

Community Transportation

Permission for Community

Swim Information Form

Transition Forms

NEW! Taking the Next Step Manual

Transition Assessments

VRS Referral (Formerly “OVR”)

Job Shadow Agreement

Work Experience Agreement

Anticipated Services

INTERN Application

So You are Going to be 18

Behavior Forms

Behavior Intervention Plan *       

FBA/BIP Student Interview

FBA/BIP Staff/Parent Interview

Staffing Form

Help! I have an MDC!

Tiered Behavioral Intervention Guidelines

Elopement PlanSample


Expulsion Chart

Suspension Chart

Students Not Yet Determined Eligible for Special Education and Related Services

Continuum of Services Matrix

Behavior Monitoring 1

Behavior Monitoring 2

Behavior Monitoring 3

Behavior Monitoring 4

Surveys and Questionnaires

Parent Questionnaire

Student Questionnaire

GE Teacher Questionnaire 1

GE Teacher Questionnaire 2

GE Teacher Questionnaire 3

GE Teacher Questionnaire 4

GE Teacher Questionnaire 5

Initial Parent Transition Assessment

Initial Student Transition Assessment

Student Transition Assessment-Diploma

Student Transition Assessment-Certificate


Medical Referral for Homebound Instruction

Consideration of Homebound Instruction Due to Behavioral Difficulties

Teacher Forms

Accommodations Chart

Accommodations Checklist

Student Profile Sheet

GE Teacher Progress Check

Teacher of Record Letter to Teachers

Teacher of Record Letter to Parents

IEP Distribution Verification Form*

Teacher of Record Change Request

iStart 7 Stationery (MS Word Format)

Consultation Notes  (MS Word format)

IEP Appointment Log

IEP Review Checklist

Data Collection Sheets

Course of Study Worksheet

Course Selection Sheet for Grades 5 & 6


Requesting accessible materials through Indiana’s Center for Accessible Materials


Evaluation Forms

Initial Referrals for Public School:


Initial Referral K-8

Initial Referral for HS

Initial Referral for Preschool           


Initial Referral Parent (All Grades)

Initial Referrals for Non Public Schools:


Initial Non Public Referral K-6 Teacher

Initial Non Public Referral 7-12 Teacher


Initial Non Public Referral K-6 Parent

Initial Non Public Referral 7-12 Parent



Reevaluation Referral Teacher (Preschool)

Reevaluation Referral Teacher(K-6)

Reevaluation Referral Teacher (7-12)


Reevaluation Referral Parent (Preschool)

Reevaluation Referral Parent (K-6)

Reevaluation Referral Parent (7-12)

Parental Request for Evaluation

Parental Request for Reevaluation

Withdrawal of Request for Evaluation

Notice of Ineligibility

Medicaid Letter to Physician

Medical Referral for OI, OHI, TBI

OT/PT Checklist

Cat Referral

Recommendation to Test Hearing

Audiological Evaluation Report

Autism Checklist

Speech Forms

Parental Request for LSI Evaluation

Parental Request for LSI Re-evaluation*

Referral for Multidisciplinary Team LI

Referral for Multidisciplinary Team SI

M Team Language Impairment Report

M Team Report Artic

M Team Report Fluency

M Team Report Voice

Social/Developmental History (for initials)

Social/Developmental History (Spanish for initials)

-For reevaluations, please use the Parent form

Hearing Screening Recommendations

Permission / Release Forms

Enrollment Form

Notice of Discontinuation of Special Education

Permission for New Enrollees

Permission for Prescription Medication

Permission for Release of Publicly Identifiable Information

Permission for Termination due to Graduation

Release of Information*

Withdrawal Form

Miscellaneous Forms

Appointment of Educational Surrogate Parent

Educational Surrogate Parent Request

Blind/Low Vision Medical Referral

Communication Protocol For Outside Therapists and Consultants

Consultation Notes  (MS Word format)

Description of FAPE worksheet

IEP Review Checklist

IREAD 3 Exemption Form

iStart 7 Stationery (MS Word Format)

Rejection of Services in a Public School

Teacher of Record Change Request

Teacher of Record Letter to Parents*

Teacher of Record Letter to Teachers*

Minutes/Percentages Charts

High School Course Numbers, Minutes and Percentages

High School Course Descriptions

Intermediate Course Numbers, Minutes and Percentages

Preschool/Primary Minutes and Percentages

Co-Teaching Forms

PowerPoint from August 18, 19 workshop

Handout from August 18.19 workshop

Planning for Co-Teaching a Unit of Study

Co-Teaching Approach: Teaching and Observing

Co-Teaching Approach: Station Teaching

Co-Teaching Approach: Parallel Teaching

Co-Teaching Approach: Alternative Teaching

Co-Teaching Approach: Teaming

Co-Teaching Approach: Teaching and Assisting

Progress Reports/Data keeping

Accommodations Chart

Accommodations Checklist

Student Profile Sheet*

GE Teacher Progress Check

Progress Report Cover Sheet

Data Collection Sheets

Data Collection Sheets:

Data Sheet 1Data Sheet 1* Data Sheet 2Data Sheet 2* Data Sheet 2Data Sheet 3* Data Sheet 4Data Sheet 4*
Data Sheet 5Data Sheet 5 Task Analysis SheetTask Analysis Sheet Weekly Data Weekly Data Sheet
Data Behavior 1Behavior Data Sheet 1 Data Behavior 2Behavior Data Sheet 2 Data Behavior 3Behavior Data Sheet 3 Data Behavior 4Behavior Data Sheet 4