IEP Binder

			

Families,

You may have questions as you navigate special education services in Clovis Unified School District. The Family Resource Center ishere to help guide you alongthe way. We want to offer support and information that will equip you to navigatethrough Special Education services within ourschool district.

Weencourage you to be an active participant in your child’s IEP meetings. This binder can help you organize your child's paperwork so you can refer to it when needed. You will also find other tips and information included inside.

Thank you,

Leann Gajarian Keeler CUSDFamilyResource Center Coordinator District Community Liaison–Special Education 559-327-8455 familyresourcecenter@cusd.com

Table of Contents

SPECIAL EDUCATION

Page 3
	Special Education Q & A
	
5
	IEP - Document
	
6
	IEP -Meeting Agenda
	
7
	Continuum of Services Chart
	
8
	Classroom Observation
	
10
	IEP Meeting Worksheet
	
12
	Glossary of Special Education Terms

PARENT RESOURCES

17
	Parent Rights- Simplified
	
18
	Who to Contact If You Have Concerns
	
19
	CUSD Family Resource Center
	
20
	Online Resources
	
21
	Additional Online Resources
	
22
	Transition Planning “Life After High School” information

RECORDS 

26
	Contact Information
	
27
	Child’s Health History
	
28
	All About Me

REPORTS 

The information provided in material does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available in this binder are for general informational purposes only. Information included may not constitute the most up-to-date legal or other information.

3

SpecialEducation Q&A

What is Special Education?

Special Education is specially designed instruction to meet the unique needs of children with disabilities. There is no cost to the parents. It is provided for children ages birth to high school graduation, or 22 years for those who qualify according to laws and regulations outlined by the Federal and Stategovernments, and whose parents consent to such services.

What are the categories of eligibility?

•	Autism

•	Deaf

•	Deaf/Blind

•	Emotional Disturbance

•	Hard-of-hearing

•	Intellectual Disability

•	Multiple Disabilities

•	Other HealthImpairment

•	Orthopedic Impairment

•	Specific Learning Disability

•	Established Medical Disability(ages 3-5)

•	Speech/LanguageImpairment

•	Traumatic Brain Injury

•	VisualImpairment

My child has a medical diagnosis; do they automatically qualify for an IEP?

Your child may have a medical diagnosis for a disability and still not qualify for special education. In general, to qualify for special education in California, (1) the child must have one or more eligible disabilities; (2) the disability must negatively affect her/his educational performance; and (3) the disability must require special education and related services.

Who participates in the IEP team meeting?

•	Parent(s) or legal guardians •	Student (as appropriate)
•	School administrator (or their designee) •           General education teacher
•	Special education teacher
•	Other professionals involved in the assessment
Examples: school nurse, school psychologist, speech therapist, etc.

4

Can I bring someone with me to an IEP meeting?

Yes. You may wish to have someone attend with you for additional support.

How often will the IEP team meet?

An annual meeting is required, but you do not have to wait until then to get your child’s IEP team together to discuss questions or concerns. As a parent, you can request a meeting and the district will schedule one within 30 days.

Can I audio record the meeting?

Yes, but you are required to give the district written notice at least 24 hours in advance that you will be recording the IEP meeting.

Are there tools to help prepare for an IEP meeting?

An “IEP Meeting Worksheet” is provided in this binder that can help organize your thoughts ahead of time.

How can I connect with other parents?

The Community Advisory Committee (CAC) is a group of parents, community members, and district staff that meets at least 4 times per year. The CAC advises the SELPA in the development and implementation of the local plan for special education. Membership is free.
To join the CAC and receive email updates of meetings: https://forms.cusd.com/cac.php

You can also check out your school’s website for other parent committees.

5

IEP-Document

The IEP is a legal document that describes your child, determines whether your child is eligible to receive Special Education services, identifies which services are appropriate for your child and specifies instructional goals and objectives. Additional information that you and school representatives believe is important to ensure an appropriate education for your child may also be included. The IEP must include, but is not limited to, thefollowing:

•	 The identification of a category of eligibility to receive Special Education services in accordance with Federalguidelines

•	Parent concerns

•	 A statement about your child’s present levels of performance (what your child is able to do now) in all developmentalareasof suspecteddisability

•	Annualgoalsfor your child(progress you expect your child to make in one year)

•	Short term objectivesfor your child (short steps leading up to thegoals)

•	When, how, and in whatwayprogress willbe evaluated

•	Special Education services neededfor your child to receive educational benefit

•	The extent to which your child will participate in thegeneral education program and have contact with typically-developing children(peers)

•	The anticipated beginning date of SpecialEducation services and dateof annual review

WhenyouandothermembersoftheIEPTeam havecompletedwritingtheIEP, you willbe asked to sign it. If you agree with the IEP, you are indicating your agreement with:

•	The present performancelevels of your child

•	His/her eligibilityto receive Special Education services

•	The Special Education services and placement offered

•	Thegoals and objectives

•	That you have been informed and understand your rights as a parent

6

IEP -Meeting Agenda

Most IEP meetings follow this basic agenda; however, changes may occur without notice.

• Welcome & introductions of IEP team members • Purpose of meeting
• Sign in for attendance

• Procedural Safeguards/Parent Rights • Parent concerns
• Assessment report review o Nurse
o Special Education Teacher o Language-Speech Specialist o Psychologist
o Other

• Parent input on present levels

• Draft goals/Objectives discussed

• Parent input on development of goals

• Program recommendation, accommodations, supports & services • Plans to facilitate transition
• Parent consent*

If you agree with the proposed IEP, you will be asked to sign the document at the meeting. Before signing though, you may wishto take it home toread it in a morerelaxed atmosphere or consult with others first. No action will be taken to provide your child Special Education services until you signand returnthe IEP.

If you do not agree with the proposed IEP, you can request anotherIEP meeting be scheduled to addressfurther parental concerns.

7

Clovis Unified School District’s Continuum of Services

This chart shows the least restrictive environment (LRE), which is General Education, up to the most restrictive.

8

ClassroomObservation

You might want to request an observation (or visit) to the recommended special education classroom proposed during the IEP. The IEP team will schedule the visit, which typically last 20-30 minutes. You can choose whether to bring your child along for the observation.

Preschool-aged: Remember that you are the parent and it is your choice to decide if it is time for your child to start attending school. Children are not required by law to attend school before age 6.

Here are some suggestions for things you might observe and questions you might ask:

1. What istheatmosphereoftheclassroom?

•	Is there a happy, relaxed feeling?

•	Are the children busy with learning activities?

•	Does the staff speak to the children with caring and respect?

•	Is theclassroom clean, with interesting toys and/or materials?

2. Willmychildbecomfortableintheclassroom?

•	How willmy child communicatehis/herneeds?

•	Canmy child maneuver within the physical arrangement?

•	Willmodifications be needed to accommodate?

3. What about personal needs?

•	Will they work on toilet training with my child?

•	Do I need to provide a change of clothing, diapers and/or wipes?

•	Where is thechanging area and/or restrooms located?

•	How will they handle my child’s special medical or diet needs?

•	Do I send a snack withmy child every day?

•	Can I send special foodor medicine?

•	Whatwill happen if my child getssick at school?

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4. Will my child have mainstreaming opportunities?

•	Whowill they be mainstreaming with?

•	Howmany times perweek will they mainstream?

•	Will the teacheror aidebe with my child at all times?

5. Will bustransportationbeprovided?

•	Is there paperwork I need to hand in to get started? •	When will it start?

6. WillIbeabletovolunteerinmychild’sclass?

•	May I stay withmy child the first few days? •	Will there be field trips?

Other questions?

_______________________________________________________________________ _______________________________________________________________________

10

IEPMeetingWorksheet

Date of meeting:	                        Location:	

Members ofthe IEP Team:

Parents:
	School Psychologist:
	
Language/SpeechSpecialist:
	School Nurse:
	
Special Ed.Teacher:
	General Ed. Teacher:
	
Program Specialist:
	Other:

Mychild's strengths:

•	Thingsmy child reallylikes:

•	Thingsmy child does well:

Areas inwhich mychild mayneed extra support:

•

•

•

(cont.)

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Some thingswe have beenworking on at homeare:

(Examples: toileting, counting, colors, sorting,matching, labeling objects)

•

Plans for next year:

•	What special services do I think my child might need?

•	Will my child need any changes in the classroomor building?

•	How will I be informed about my child’s progress?Howoften?

Additional thingsI thinkthe teacher should know about mychild:

•

•

•

Questions:

•

•

•

12

Glossary of SpecialEducationTerms

AssemblyBill

•	A bill proposed bythe State Assembly.

Assessment

•	 Observations and testing of children to identifythe strengths and weaknesses of the child in order to develop an appropriateeducational plan

Audiological Services

•	 Includes identifying children with hearing loss andproviding servicesthat will help children with hearing lossesmaximizetheir strengths andabilities

AuditoryProcessing

•	 The ability to understand and use information that is heard, both words as well as other non-verbal sounds

Autism (AUT)

•	A pervasive developmental disorder, usuallycharacterized bylimitedcommunicationskills and social interaction

Blind

•	See visuallyimpaired

California Children’s Services(CCS)

•	Provides specialized medical care andrehabilitationfor physicallyimpaired children

CaliforniaEducation

•	The bodyof regulations whichgovern EducationCode in the State of California

Central ValleyRegional Center (CVRC)

•	 The Central Valley Regional Center provides diagnosis, evaluation and counseling services. It also acts as a "coordinator" of services which are available to people with developmental disabilities provided byother communityagencies

Classroom BasedInstruction

•	 Thegoalsof theIEP aremet withinthe environment of the student’sclass insteadof being pulled out of the classroom to work individuallywith the teacher or with smallgroups.

CommunityAdvisoryCommittee (CAC)

•	A legally mandated organization of parents, school personnel and various agency representatives, which advises special education administrators in the development, revision, and evaluation of special education programs and policies. Refer to “Parents are Partners”- CACsection.

CommunityBased Instruction

•	A form of instruction in which IEP goals are met in a "natural" environment within the community. For example, math, sequencing, travel, and social skills may be developed through a trip to the grocerystore.

Compliance Complaint

•	 The issue and/or resolution process involved when there is an alleged violation by the public educational agency of any Federal or State law or regulation governing special education.

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Deaf

•	A term usedto denotea person whohas minimalor no hearing.

DesignatedInstructional Services(DIS)

•	Also known as Related Services, Specialized Instruction, and/or Support Services. Identified through an assessment and written on an IEP, as necessary, for a child to benefit from Special Education (e.g., speech/language services, adapted P.E., and/or vision services such as, orientation andmobilitytraining).

Due Process

•	 The legal procedures set up to resolve disagreements between parents and school districts over some partof a child’s Special Education program.

EmotionallyDisturbed(ED)

•	Having an emotional problem, which has existed for a marked degree and over a long period of timethat interferes with learning.

English Language Learner (ELL)

•	See Limited English Proficiency

Extended School Year

•	Special Education program extended into summer when the IEP team determines need, based upon a child’s regression.

Fair Hearing

•	 A formal hearing that is called by parents or school district personal. Issues that may be considered under the Fair Hearing procedure are limited to eligibility, assessment, the IEP and placement of individuals with special needs.

Free and Appropriate PublicEducation(FAPE):

•	Free Appropriate Public Education (FAPE) is an educational right of children with disabilities in the United States that is guaranteed by the Rehabilitation Act of 1973 and the Individuals with Disabilities Education Act (IDEA).

Hard of Hearing(HOH)

•	 A term used for those people whose hearing is disabled to an extent that makes it difficult to understandspeech throughthe ear, with or without a hearing aid.
Or

Having some degreeof hearing loss rangingfrommild to profound. Or

A term that refers to a hearing loss where there may be enough residual hearing that an auditory device, such as a hearing aid or FM system, provides adequate assistance to process speech.
HearingImpaired or HearingLoss

•	A term usedto genericallyrefer to anychild with anytype and degree of hearing loss. Or

A term meaning an impairment in hearing, whether permanent or fluctuating, that adversely affects the child's educational performance but that is not included under the definition of “Deafness”
. IndividualizedEducationProgram(IEP)
•     A written document developed by an educational team, including the parent, that serves as a practical plan for instruction and deliver of serve to individuals with a disability or specialcondition.

IndividualizedEducationProgram(IEP) Team

•	 Composed of an administrator or his/her designee, the student’s teacher, and the parents. Other members may include the student, other individuals selected by the parent or the IEP chairperson, andthose who have conductedassessments on the student.

14

IndividualizedTransition Plan (ITP)

•	 A plan similar to the IEP which specifies services to be provided for students age 16 and older for the purpose of transition from high school to life after school. A trans-disciplinary team developing the IEP includes parents, student, school personnel, and agency representatives.

Individualswith Exceptional (Special) Needs

•	 Individuals from infancy through age 22, identified by an Individualized Education Program (IEP) Team, as having a disability of condition that requires specialized instruction and/or services.

Integration

•	See Mainstreaming

Intellectual Disability(ID)

•	 ID is a disabilitycharacterized by significant limitations in both intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills and that adverselyaffects a student’s educationalperformance.

Language Delayed

•	A delayin the development of a child’s abilityto use or understandlanguage.

Language Speech Service

•	 Also known as, Speech/Language Service. Service that helps children learn to speak and use language.A speech / language pathologist (SLP) provides these services.

Learning Disability

•	 A disorder in one or more of the basic psychological processes involved in understanding or using spoken and/or written language, as well as, severe discrepancy between intellectual ability and achievement.

Least Restrictive Environment (LRE)

•	For any child, the educational setting in which he/she can succeed that is most like the regular classroom.

Limited English Proficiency(LEP)

•	Abilityto speak English is determinedto be limited, basedon an assessment.

Local Plan

•	 The model for the delivery of programs and services, which will be provided by schools to meet the education needs of eligible individuals with special needs. Each SELPA district develops a new plan every three years, which must be accepted by the State Department of Education.

Mainstreaming

•	 A term referring to the time during which a Special Education student participates in general education activities, either academic or non-academic.

Multidisciplinary

•	 Using a combination of several disciplines for a common purpose; i.e., assessment or an approach to child guidance

Multiple Disabilities

•	Having two or more disabilities, which cause educational problems.

Non-Public School/Agency

•	 Private, non-sectarian, school or agency, wh ich has been licensed by the State Department of Educationto meet basicstandards.

15

Other HealthImpaired(OHI)

•	Disability category included in the Individuals with Disabilities Education Act (IDEA). OHI refers to having a disability caused by disease, condition, disorder, or injury that substantially affects strength, vitality, or alertness. These disabilities include, but are not limited to, congenital anomalies, cerebral palsy (CP), asthma, diabetes, tracheotomies and colostomies.

Orientation andMobility(OM)

•	 Training for an individual with visual impairments to know howto move through space and develop an awareness of where his/her bodyis in space.

OrthopedicallyImpaired(OI)

•	 Students with specific orthopedic or health problems, w hic h adversely affect their education performance.
Or

A term for students with a severe orthopedic impairment that adversely affects a child’s educational performance.

Program Placement

•	 The specific system of delivery (DIS, RSP, or SDC) that meets the child’s individual needs, as identified inthe IEP.

Program Specialist

•	 An administrative person who assists district personnel in finding an appropriate program for children in Special Education. They are the primarylink between the Special Education Department and school site personnel.

Psychological Services

•	Includes psychological assessment, psychological counseling for children and parents. Also includes, consultation with teachers and specialists.

Referral

•	The request to identify and assess a child’s possible Special Education needs. A parent, teacher, medical personnel, or anyone with specific knowledge of the child may make a referral.

Related Services •	See DIS

Resource Specialist Program (RSP)

•	 Students receiving Special Education instruction by a resource teacher for less than 50% of the day are enrolled in RSP. The student with special needs may receive his or her RSP services in general education classrooms, or special programs in each school, as specified in the IEP.

SeverelyDisabled (SD)

•	A disability category containing the currently used labels of: developmentally delayed, severely emotionallydisturbed, autistic, andmultiple disabilities.
Or

An individual with a disability who has a severe physical or mental impairment, which seriously limits one or more functional capacities (such as mobility, communication, self-care, self- direction, interpersonalskills, educational skills).

Special DayClass (SDC)

•	 Class for students with needs that cannot be met in a general education setting. The student spends the majority of his/her day in this classroom. A teacher with a credentialintheappropriate Special Education area provides instruction in school.

16

Special Education

•	Those programs and/or services provided for individuals with special needs. It is instruction that is specificallydesigned for the student to meet his/her unique needs.

Special EducationLocal Plan Area(SELPA)

•	The district or county designated as the agency responsible to coordinate the administration and deliver of Special Education services, under the supervision of a director.

Special Needs

•	Services needed beyond those that are usually provided in General Education. May be referredto as Exceptional Needs.

SpeechImpaired

•	 Students who have an impairment in the ability to use or understand language and which adversely effects their learning.

Student StudyTeam (SST)

•	 A general education process designed to make preliminarymodifications within the general education program of a student not succeeding in class. Used as a pre-referral before a Special Education referral is completed.

Transition

•	 Services provided to students age 16 and older (age 14, if appropriate) to transition from secondary schoolto lifeafter high school.

Or

•	 “Transition” in Special Education programs, in general, refers the movement from one program to another. The "official" term, however, usually refers to the transition from school-basedto adult services (see ITP).
Transitions can be:

o From onegrade classroom to another o From one schoolto another
o From one programto another

o From schoolto postsecondary, college, vocational program, or other program

VisuallyImpaired(VI)

•	A student is visually impaired (VI) if the visual impairment, even with correction, adversely affects educational performance. This includes blind and lowvisionstudents.

17

Parent Rights (A simplified version)

For a more complete document, see the Notice of Procedural Safeguards.

According to IDEA, you as the parent have the right to:

1. Refer your child for an assessment;

2. Receive from the district an explanation of your rights and procedural safeguards that are provided by the law;

3. Give your consent before any educational assessment or placement in special education can occur;

4. Examine your child’s school records, have them explained to you and obtain copies;

5. Request in writing to have the district consider amending the records if you believe the educational records are inaccurate, misleading or violate the privacy or other rights of your child;

6. Agree to a time and place for the annual review meeting to develop your child’s Individualized Educational Program (IEP);

7. Electronically record the IEP meeting upon a prior notification to team members of at least 24 hours;

8. Request the school district to hold those meetings in your primary language and to make special arrangements for your disability, if any, so that you can fully participate;

9. Participate in the annual IEP;

10. Be consulted when major changes in your child’s education are being considered;

11. Request an independent educational assessment, which may or may not be at your expense, if you disagree with the district’s assessment;

12. Request a due process hearing if serious disagreements regarding your child’s identification, assessment, or education, cannot be resolved.

18

CUSD Family Resource Center

19

The Family Resource Center (FRC) offers support and service to CUSD families with children ages birth to 22 who are at risk of having, or do have, special medical and development needs.

The CUSD FRC believes that support services for children should be family-focused. We believe that informed and loving parents, families, or guardians are effective advocates and good case managers for children with special needs. Most families have had no previous training for this challenge. Therefore, parents must have access to information, knowledge, support and the experience of other parents and families.

We also believe that it is important to have a collaborative relationship with the professionals serving our children.

Services we offer:

•	Information & Referrals

o Linking families with District and Communityservices

•	FamilySupport

o Providing options when requested, such as, one-to-one peer support

•	CommunityOutreach

o Increasing public awareness of disabilities and the service system

•	Advocacy

o Strengthening parents’knowledge and decisionmaking abilities

•	Workshops and Seminars

o Trainingsfor parents andprofessionals

CUSD FamilyResourceCenter 965 N. Sunnyside Ave.
Clovis, CA 93611 (559) 327-8455

familyresourcecenter@cusd.com

20

Online Resources

21

Additional Online Resources

State of California Dept. of Developmental Services http://www.dds.ca.gov

•	The California Department of Developmental Services is the agency through which the State of California provides services and supports to individuals with developmental disabilities. You will be able to find information about California Codes, laws and regulations, as well as resources

California Department of Education/Special Education http://www.cde.ca.gov

•	Information and resources to serve the unique needs of persons with disabilities so that each person will meet or exceed high standards of achievement in academic and nonacademic skills

State Council on Developmental Disabilities http://www.scdd.ca.gov

•	The State Council on Developmental Disabilities (SCDD) is established by state and federal law as an independent state agency to ensure that people with developmental disabilities and their families receive the services and supports they need

Center for Disease Control https://www.cdc.gov/ncbddd/actearly/milestones/index.html

•	The Center for Disease Control has helpful developmental information and free resourcesthrough their “Learn the Signs, Act Early” campaign

Student has met all
		
requirements met for
		
high school graduation.
	
22

Transition Planning

Once your child reaches 7th grade, it is time to start thinking about planning for the future. For students with an IEP, it is important for families to understand the difference between a high school diploma and a certificate of completion. Carefully consider and discuss with the IEP team, what program placements or curriculum modifications may impact their ability to get a diploma.

			
Diploma
	
Certificate of Completion
	
	?

What does it mean?
		
Student has completed high school.
	
	Once achieved, does Special
			Yes
			No. If a student with an IEP does not
		
	Education end?
				receive a high school diploma, they are eligible for services until they reach age 22 through the Adult Transition Program

			(ATP).
		
	Are accommodations
			Yes
			Yes
		
	allowed?

	Are curriculum modifications
			Maybe.
			Yes
		
	allowed?
			Discuss with IEP team.

	Accepted by the military?
			Yes
			No

	Accepted by colleges?
			Yes
			Yes. Although, certain courses have
		
			prerequisites.

	Accepted by employers?
			Yes
			Varies

	Eligible for Federal Student
			Yes
			No. Students must have a diploma or
		
	Aid (Financial Aid)?
				GED to qualify.

23

Individualized Transition Plan (ITP)

Under federal law, transition planning for students with an IEP must start by the time the student turns 16 years old. The goal is for them to be as independent as possible once they reach adulthood. The ITP focuses on Education and or Training, Employment, and Daily Life skills (when appropriate).
Some things to keep in mind:

•	Discuss what your child sees for their future

o What are their unique talents and interests?

o What do they want in life now and in the future?

•	Discuss with the IEP team potential types of post-graduation options

o What are their options for achieving those goals? College, Vocational Program, Employment?
o Are there barriers to getting what they want from school and their community?

•	Consider who else should be involved in the ITP process

o Encourage your child to self-advocate and participate in IEP meetings, as much as they are able.
o Are there community agencies or service coordinators that should attend?

Ideally, the person-centered planning process can strengthen the transition to post-high school activities by:

•	Enhancing the quality of assessment and planning activities for both high school transition services and adult service agencies serving youth with disabilities

•	Fostering positive working relationships between families and professionals

•	Providing a way for educators and case managers from other agencies to better coordinate their services

•	Connecting families to adult service agencies before a student leaves high school

•	Helping ensure that services support the youth’s goals and lead to successful outcomes

•	Helping identify and encourage natural supports in the community

24

Life After High School

When a person turns 18, he or she becomes an adult and gains the same rights andresponsibilities that other adults have, regardless of whether he or she has a disability. As a family, consider and discuss changes that take place once students become adults. What self-management skills will your child be in charge of and in what areas might they need assistance? Below is a list of the areas that changes can take place:

•	 Medical – Will you be able to make medical decisions for them in cases of emergency, access records for billing questions, or have discussions with medical personnel?

•	Insurance – Will your child still be eligible for coverage on your policy? Are they eligible for Government Assistance, such as; SSI, Medi-Cal, IHSS, or other programs?

•	Financial- Will you need to have discussions with their college financial aid officers, government aid workers, banking institutions, loan officers?

•	College, Vocational Programs, Adult Programs- Can your child navigate services without assistance?

•	 Selective Service (for Males)- Does your son still need to register even if he has a disability?

•	 Legal – Do you and your child need to meet with an attorney before they turn 18 to discuss what legal documents might be needed?

•	Education- See “Education” page next

25

Education

At the college level students no longer have an IEP. Special Educational Services under IDEA (Individuals with Disabilities Act) end at the public school. Colleges comply with ADA (Americans with Disabilities Act), Section 504 of the Rehabilitation Act and the Civil Rights Restoration Act. College students have civil rights, but no “education” rights.

HIGH SCHOOL	COLLEGE

•	School personnel are responsible for identifying a student with a disability
	
•	Student must “self-identify”, provide documentation of disability and request help with the Disabled Student Programs and Services team.

•	School must provide the assessment of disability, classify disability, and involve parents in the process (IEP)
	
•	 Adult Student will work with DSPS (Disabled	Student	Programs	and Services), to create a plan to meet their needs.

•	School staff will discuss academic progress with parents or legal guardians
	
•	Student is considered an adult with privacy and confidentiality protections. Staff cannot talk with parents or legal guardians about the student’s academic progress or finances

•	School must coordinate the provision of all services, monitor progress, and evaluate results
	
•	College must provide reasonable accommodations for students who qualify

Special Education Law
•	The Individuals with Disabilities Education Act (IDEA) provides the mandate and funding to schools for in-school special education services as well as transportation/ buses to school, physical, occupational, speech therapy, and tutoring
	
Civil Rights Law
•	American with Disabilities Act (ADA) and Section 504 of the Rehabilitation
•	Colleges are required only to offer accommodations & support services; not services of a personal nature.
•	Tutoring is not required under ADA. Some colleges offer tutoring through disability services and some colleges have tutoring centers for all students.
•	Foreign Language waivers & other course substitutions are not automatic.

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Contact Information

Name:
	PhoneNumber:
	
Parent/Guardian:
		
Parent/Guardian:
		
Caregiver:
		
Primary Doctor:
		
Hospital:
		
Urgent Care:
		
Pharmacy:
		
Nearest Relative:
		
Neighbor:
		
Medical Supply Co.:
		
Social Worker:
		
Other:

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Child’s Health History

Child’s Name_________________________________________

Date of Birth___________

Parent/Guardian Name _____________________________________________________

Current diagnosis:_________________________________________________________

Diagnosed by whom? ______________________________________________________

Date of diagnosis? _________________

Birth Information:

Hospital of birth ____________________

County of birth _____________________

Attending physician _________________

Birth weight _____________ Length _______________ Blood Type __________________

Birth experience____________________________________________________________

Concerns at birth___________________________________________________________ _________________________________________________________________________

APGAR Scores (Activity, Pulse, Grimace, Appearance & Respiration)__________________

New born hearing screening - Pass/Fail _________________________________________

Concerns & comments_______________________________________________________

Medical Concerns:

Past Illnesses:_____________________________________________________________

Past surgeries (date/type):________________________________________________________________

_________________________________________________________________________

Other:____________________________________________________________________

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