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Staff Members

504 Forms

about 1 month 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.

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

(English) Form Link

(Spanish) Form Link

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

  • Once it is completed you will upload using “Attach Document” in Eduphoria.

** 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 (Aware - initial or removal only)

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

  • Form 2: Educational Screening/Existing Evaluation Data (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.

 

504 Initial Committee Meeting (Academic Only)

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

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

  • Form 9:  Student 504 Plan (Aware)

  • Form 23: STAAR Testing Page (Aware)

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

  • Form 21: Section 504 Secondary Service Provider Receipt of Accommodation/504 Plan (Aware)


504 Initial Committee Meeting (Academic/ Behavior)

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

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

  • Form 9:  Student 504 Plan (Aware)

  • Form 23: STAAR Testing Page (Aware)

  • Form 12:  Behavior Intervention Plan (Aware)

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

  • Form 21: Section 504 Secondary Service Provider Receipt of Accommodation/504 Plan (Aware)

 

504 Initial Committee Meeting (Dyslexia)

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

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

  • Form 9:  Student 504 Plan (Aware)

  • Form 23: STAAR Testing Page (Aware)

  • Form 13:  Dyslexia Review/RE-evaluation Checklist (Aware)

  • Form 14: Initial Dyslexia Program Evaluation (Aware)

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

  • Form 21: Section 504 Secondary Service Provider Receipt of Accommodation/504 Plan (Aware)


Manifest Determination Meeting

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

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

  • Form 24:  Manifest Determination Meeting Checklist (Aware)

  • Form 25:  Manifest Determination Form (Aware)

  • Form 9:  Student 504 Plan (Aware)

  • Form 23: STAAR Testing Page (Aware)

  • Form 12: Behavior Intervention Plan (Aware)

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

  • Form 21: Section 504 Secondary Service Provider Receipt of Accommodation/504 Plan (Aware)

 

Homebound Meeting

  • 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 9:  Student 504 Plan (Aware)

  • Form 23: STAAR Testing Page (Aware)

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

  • Form 21: Section 504 Secondary Service Provider Receipt of Accommodation/504 Plan (Aware)

 

Individual Student Health Plan Meeting

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

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

  • Form 16: Individual Student Health Plan (Aware)

  • Form 9:  Student 504 Plan (Aware)

  • Form 23: STAAR Testing Page (Aware)

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

  • Form 21: Section 504 Secondary Service Provider Receipt of Accommodation/504 Plan (Aware)

 

Revise/Renewal Process

Students eligible to receive protections under Section 504 shall periodically be reevaluated, specifically, at least every three years, or prior to a significant change in placement.

A “significant change in placement” means any change in the student’s accommodation plan, including the instructional arrangement, for more than ten (10) consecutive school days. An advance in grade level shall not constitute a significant change in placement as long as the accommodation plan remains applicable.

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

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

  • Form 10A: 504 Review/Reevaluation (Aware)

  • Form 9:  Student 504 Plan (Aware)

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

  • Form 21: Section 504 Secondary Service Provider Receipt of Accommodation/504 Plan (Aware)

  • Form 23: STAAR Testing Page

 

 Termination of Qualifications / Accommodations

If the Section 504 committee suspects and/or determines that a student no longer requires an accommodation and/or accommodation plan, the committee may determine that an update to the student individualized accommodation plan be made.

A reevaluation MUST be done and the committee may determine that a revision to the student’s accommodation plan may be made up to and including termination of qualification.

  • Form 10A: 504 Review/Reevaluation (Aware)

    • Use “Attach Document” to place reevaluation in Aware

  • Form 26: 504 Termination of Qualifications / Accommodations (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)

  • Form 23: STAAR Testing Page (Aware)