Student:

Date:

 

Form

Description

When to Use

 

A Guide to Section 504

This document describes the process in detail and can be used to   educate staff, parents, and community members. It can also serve as a   resource for administrators and building 504 coordinators.

Initial inquiry about Section 504 from families, to educate staff or   service agencies

 

Section 504 Referral Form

This is the document that begins the 504 process for a student. It   provides the basic information needed to determine if a 504 evaluation is   warranted or necessary.

When parent or school staff is interested in beginning the 504   process for a student.

 

Notice to Parent of 504 Referral and Evaluation

Following the receipt of the referral form and the decision that an
  evaluation should be pursued, this form is sent to parents to gain consent   for the evaluation. The next form,
Section 504   Parental Procedural Rights, should be included.

After determining that the evaluation should be pursued to gain   consent for evaluation / send with parental rights.

 

Section 504 Parental Procedural Rights

A document provided to the parent that explains their rights under   Section 504, available as a brochure or a one page document.

Send with consent for evaluation and offer a new copy at each 504   meeting for the student.

 

Eligibility Data – Classroom Teacher Feedback

A document designed to seek information from teachers about a   student’s classroom performance. This is one part of the evaluation data   needed to determine eligibility.

During the evaluation process when determining 504 eligibility.

 

Section 504 Eligibility Evaluation Form

This form is to be used by the 504 team during the evaluation   meeting. It prompts the team to ask the right questions and review the   appropriate data. This form should be used at the initial eligibility   determination and at each annual review.

At the eligibility determination meeting and each annual review to   summarize the data.

 

Eligibility Determination

This form is used at the conclusion of the evaluation meeting to document   the decision of the team.

At the initial eligibility determination meeting, 3 year   re-evaluation.

 

Section 504 Accommodation Plan

Should the 504 team determine that the student is eligible, this form   is used to design and document appropriate accommodations. The completed plan   is distributed to all teachers who serve the student. Included with this document is the Section   504 Annual Review form.

When writing the initial plan, at annual reviews, and to document   dismissal from 504.

 

Receipt of 504 Accommodation Plan

This form serves as the cover page for the accommodation plan when   distributed to teachers. These should be signed and returned to the building   504 coordinator to file with the student’s 504 plan.

When the plan is distributed to teachers to inform them and ensure   agreement in carrying out the plan.

 

Section 504 Due Process Procedure

This document describes the procedure for responding to a complaint   of non-compliance.

When there is a family concern that cannot be resolved at the   building level.

 

Source:Grant Wood Area Education Agency. Section 504 Document Checklist. http://www.aea10.k12.ia.us/section504/info.html

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