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Staff Members

504 Forms

3 months ago

LISD 504 Forms Flowchart

 

Initial 504 Referral Initiated by the teacher.

                -This form is completed in Formspace by the teacher.

 

Parent Forms Required for Evaluation Under Section 504: (These must be obtained before any further action is taken.)

·         Form 4(English) or  4A(Spanish):  Parent Notice & Consent for 504 Evaluation (Aware)

-You will need to assign this to the student and complete the required fields.

-Once you are finished completing the required fields print this form out.

·         Form 5(English) or 5A (Spanish):  Notice of Parent and Student Rights Under 504 (Aware)

-You will need to assign this to the student and complete the required fields.

-Once you are finished completing the required fields print this form out.

·         Form 6(English) or 6A (Spanish):  Parent Input Form

**These forms are not in Eduphoria.  The links below will take you each for so you can print it out.

Form 6 (English) Form Link

Form 6A (Spanish) Form Link

-Print this out and send it home to be completed.

-Once it is completed you will upload it at the end of Form 1.

** Notify the parent/guardian by phone of the need for testing, what forms will be coming home, and what to do with them.

**You will need to send the completed copies of all three forms home to be signed and returned before you can proceed with a 504 evaluation.

 

Determination to Begin the 504 Process: (This is the data gathering phase once parent permission is obtained.)

·         Form 1: Student Data Information/Determination Form (Aware)

-This form is a data collection form which houses all the data needed to make a determination for 504 services

·         Form 2: Student Health Information Form (Formspace)

-You will send the nurse an email to complete form 2 in formspace.

-The nurse will fill out this form in Formspace and you will get an email when she is finished and she has submitted it.

-You will upload the completed form to Form 1 in the appropriate spot.

·         Form 3: Teacher Input Form (Listed by Subject in Aware)

-Teachers will need to assign this form to that student in Eduphoria and complete it right after they submit the 504 referral in Formspace.

-Once it is completed you will be able to print it out and utilize the data for the Form 1 for the 504 meeting.

*If any screenings such as dyslexia, Irlen, or Vanderbilt need to be complete, they can be completed at this time.

 

**At this point you will want to complete all possible fields in Form 8 and print it.  Use this form to direct you to which forms you need for what type of meeting. 

 

504 Initial Committee Meeting (Academic Only)

*Follow procedures found on Form 8:  504 Committee Meeting Checklist in Aware

·         Form 7:  Parent Notification of 504 Meeting (Aware)

·         Form 5:  Notice of Parent and Student Rights Under 504 (Aware)

·         Form 8:  504 Committee Meeting Checklist (Aware)

·         Form 9:  Student 504 Plan (Aware)

·         Form 11: 504 Committee Members Signature Page (Aware)

 

504 Initial Committee Meeting (Academic/ Behavior)

*Follow procedures found on Form 8:  504 Committee Meeting Checklist in Aware

·         Form 7:  Parent Notification of 504 Meeting (Aware)

·         Form 5:  Notice of Parent and Student Rights Under 504 (Aware)

·         Form 8:  504 Committee Meeting Checklist (Aware)

·         Form 9:  Student 504 Plan (Aware)

·         Form 12:  Behavior Intervention Plan (Aware)

·         Form 11: 504 Committee Members Signature Page (Aware)

504 Initial Committee Meeting (Dyslexia)

*Follow procedures found on Form 8:  504 Committee Meeting Checklist in Aware

·         Form 7:  Parent Notification of 504 Meeting (Aware)

·         Form 5:  Notice of Parent and Student Rights Under 504 (Aware)

·         Form 8:  504 Committee Meeting Checklist (Aware)

·         Form 9:  Student 504 Plan (Aware)

·         Form 13:   Dyslexia Checklist/Qualification Form (Aware)

·         Form 11: 504 Committee Members Signature Page (Aware)

 

Manifest Determination Meeting

*Follow procedures found on Form 8:  504 Committee Meeting Checklist in Aware

·         Form 7:  Parent Notification of 504 Meeting (Aware)

·         Form 5:  Notice of Parent and Student Rights Under 504 (Aware)

·         Form 21:  Manifest Determination Meeting Checklist (Aware)

·         Form 14:  Manifest Determination Form (Aware)

·         Form 9:  Student 504 Plan (Aware)

·         Form 12: Behavior Intervention Plan (Aware)

·         Form 11: 504 Committee Members Signature Page (Aware)


Homebound Meeting

*Follow procedures found on Form 8:  504 Committee Meeting Checklist in Aware

·         Form 7:  Parent Notification of 504 Meeting (Aware)

·         Form 5:  Notice of Parent and Student Rights Under 504 (Aware)

·         Form 15:  Homebound Determination Form (Aware)

·         Form 15A:  Parent/ Student Acknowledgment Form (Aware)

-This form will need to be printed and signed during the meeting and uploaded at the bottom of Form 15.

·         Form 15B:  Physician Referral Form (This form is not in Aware) The link to this form is below.

-Link to Form 15B

*Print it out and have the parent take it to the physician to fill out.

*Once it is brought back completed you will upload it at the bottom of From 15 in Eduphoria.

·         Form 8:  504 Committee Meeting Checklist (Aware)

·         Form 9:  Student 504 Plan (Aware)

·         Form 11: 504 Committee Members Signature Page (Aware)


Individual Student Health Plan Meeting

*Follow procedures found on Form 8:  504 Committee Meeting Checklist in Aware

·         Form 7:  Parent Notification of 504 Meeting (Aware)

·         Form 5:  Notice of Parent and Student Rights Under 504 (Aware)

·         Form 22:  Student Health Plan Meeting Checklist (Aware)A

·         Form 16: Individual Student Health Plan (Aware)

·         Form 9:  Student 504 Plan (Aware)

·         Form 11: 504 Committee Members Signature Page (Aware)


Misc. Forms

·         Form 17:  Amendment to 504 Plan (Aware)

·         Form 18:  Transportation Supplement (Aware)

·         Form 19:  Consent for Release of Medical Information (Aware)

·         Form 20:  Parent Consent for Release of Information of Visually Impaired Student (Aware)

By School ADM