"Iep Forms Checklist Template"

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IEP Forms Checklist: Initial Evaluation
Date of IEP Meeting: ___/___/___ 
Date received IEP ___/___/___ 
Date returned for checks ___/___/___ 
Student:_________________Teacher:________________
Check
Status
Form
Contingent Release of Records permission letter, signed by parent
Mandatory R-1 Referral
Mandatory IE-1 Notice of Receipt of Referral
Mandatory EW-1 Worksheet
Must
IE-2 Notice No Additional Assessments
Choose:
IE-3 Notice and Consent to Assess
STOP!
Completes initial paperwork. Give to Lead Teacher once completed . Date sent to Ad. Bldg. __/__/__
M-3 Agreement to Extend the time to Complete the Evaluation of a Child
Contingent
Suspected of having a Specific Learning Disability
Contingent M-2 Extend Time Limit for Transfer
Mandatory I-3 Use as cover for evaluation report check *Evaluation box only*
Mandatory ER-1 Evaluation & Determination of Eligibility
Mandatory Official DPI Eligibility Criteria Checklist (O-net form)
ER-1A-
Attach all team members reports here. NOTE: Include your classroom Teacher’s report. Document
Mandatory
Observation that was conducted and give summary and dates. PASTE this summary into the ER-1.
Contingent ER-2 Evaluation & SLD Documentation
Contingent ER-3 Evaluation & Braille Determination
Contingent M-4 Parent Refusal of Consent for Special Education
Contingent
ER-4 Notice that Child is not a Child With Disability.
Mandatory I-1 Invitation with only evaluation checked
Evaluation paperwork completed. No additional IEP forms are required unless child qualifies
If child qualifies for special education services follow and complete P-109.
IT MUST BE SIGNED BY THE PARENT.
Hold an Annual IEP and follow the Annual IEP Checklist
Mandatory
Fill out and send in
Green Sheet
attached to top of Initial IEP. 
Spot ✔ ⃞
Read Completely ⃞
Date sent to be archived: ___/___/___ 
Lead Teacher_________________ Archive ⃞
Green Cover Sheet ⃞
1/16/2012 
IEP Forms Checklist: Initial Evaluation
Date of IEP Meeting: ___/___/___ 
Date received IEP ___/___/___ 
Date returned for checks ___/___/___ 
Student:_________________Teacher:________________
Check
Status
Form
Contingent Release of Records permission letter, signed by parent
Mandatory R-1 Referral
Mandatory IE-1 Notice of Receipt of Referral
Mandatory EW-1 Worksheet
Must
IE-2 Notice No Additional Assessments
Choose:
IE-3 Notice and Consent to Assess
STOP!
Completes initial paperwork. Give to Lead Teacher once completed . Date sent to Ad. Bldg. __/__/__
M-3 Agreement to Extend the time to Complete the Evaluation of a Child
Contingent
Suspected of having a Specific Learning Disability
Contingent M-2 Extend Time Limit for Transfer
Mandatory I-3 Use as cover for evaluation report check *Evaluation box only*
Mandatory ER-1 Evaluation & Determination of Eligibility
Mandatory Official DPI Eligibility Criteria Checklist (O-net form)
ER-1A-
Attach all team members reports here. NOTE: Include your classroom Teacher’s report. Document
Mandatory
Observation that was conducted and give summary and dates. PASTE this summary into the ER-1.
Contingent ER-2 Evaluation & SLD Documentation
Contingent ER-3 Evaluation & Braille Determination
Contingent M-4 Parent Refusal of Consent for Special Education
Contingent
ER-4 Notice that Child is not a Child With Disability.
Mandatory I-1 Invitation with only evaluation checked
Evaluation paperwork completed. No additional IEP forms are required unless child qualifies
If child qualifies for special education services follow and complete P-109.
IT MUST BE SIGNED BY THE PARENT.
Hold an Annual IEP and follow the Annual IEP Checklist
Mandatory
Fill out and send in
Green Sheet
attached to top of Initial IEP. 
Spot ✔ ⃞
Read Completely ⃞
Date sent to be archived: ___/___/___ 
Lead Teacher_________________ Archive ⃞
Green Cover Sheet ⃞
1/16/2012