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		PROGRAMS & SERVICES: SPECIAL EDUCATION: FORMS (Updated 6/6/08)     This page contains an alphabetical list of various forms created to assist educators, administrators and families in providing special education services.     FORMS (Updated 6/6/08)       Alternate Assessment Decision-Making Process: Matching Students to Assessment Options This form is designed to be used by student planning team members who may be unfamiliar with or new to the state's alternate assessment process. It provides a detailed process for determining which alternate assessment is most appropriate for students. While this form is helpful in guiding teams through the decision making process, it does not need to be submitted to the Department of Education. Only the Documentation of Eligibility for Alternate Assessment form (listed above) and a student plan are necessary for accountability approval. View additional alternate assessment forms.       Documentation of Eligibility for Alternate Assessment This form is required for Department of Education approval of all alternate assessments for inclusion in the school accountability index. In order to be considered for approval, this form must be completed accurately and accompanied by the most current student plan. Student plans must include levels of performance. View additional alternate assessment forms.       Due Process System Information & Forms A special education due process hearing is a formal review conducted by a trained, impartial hearing officer appointed by the Vermont Department of Education. Due process complaints may be filed with the department regarding special education and 504 issues for students. On August 24, 2006, new special education rules went into effect that incorporated comments from school and parent representatives. Two separate forms have been developed for filing a due process complaint; one for parents and one for school districts. A hearing may be requested in writing using the form(s) provided below. For questions or concerns about the process, contact Susan Boyd at (802) 828-3136. For Parents Filing a Due Process Complaint This packet download contains background information, a copy of the applicable Vermont State Board of Education Rules dealing with due process complaints, a parent complaint form, and sample timelines for completion of the hearing. Use this document to submit a due process complaint to resolve a disagreement about the identification, evaluation, eligibility or placement of your student or regarding the provision of a free appropriate public education for your student under the Individuals with Disabilities Education Improvement Act (IDEIA). NOTE: The parent complaint form is offered in the formats below. To complete the district form using a word processing program, use either the RTF or Word version.       Due Process Form Due Process Form Due Process Form       For Districts Filing a Due Process Complaint On August 24, 2006, new special education rules went into effect that incorporated comments from school and parent representatives. This memo download contains information about the revised due process system to ensure a fair and faster resolution of the issues regarding a student's education program. NOTE: The district complaint form is offered in the formats below. To complete the district form using a word processing program, use either the RTF or Word version. Due Process Form Due Process Form Due Process Form       Responsiveness to Instruction (RtI) Readiness Tool This updated self-assessment tool will help schools to determine their current readiness status for RtI implementation with a greater focus on fidelity and integrity of their model. Identification of Specific Learning Disabilities (Added 6/6/08) Field Memo #08-07 clarifies the conditions to be met regarding the identification of a specific learning disability as discussed in department Special Education Regulations adopted September 17, 2007. The memo articulates federal regulations and identifies conditions that must be met whether using a discrepancy model or a responsiveness to instruction model for the identification of specific learning disabilities. The field memo further clarifies documentation that must be included as part of a comprehensive evaluation within a responsiveness to instruction model of student support. Responsiveness to Instruction (RtI) Readiness Memo View Field Memo #06-01 dated February 6, 2006 Responsiveness to Instruction (RtI) Topic Group Report The final report of the responsiveness to instruction (RtI) topic group, in response to the changes in the IDEIA 2004, identifies possible next steps for using RtI in lieu of the discrepancy model for identification of students with specific learning disabilities. The report includes implications for change within general education in order for this to occur. A Student Support Method to Attain School Quality Standards Using RtI as a Decision-Making Tool  An RtI decision-making model is consistent with elements identified in the School Quality Standards and Act 117. This document has been developed to help teams make decisions about how already existing practices support a decision-making RtI model. It can help to provide a framework for teams to develop a plan that identifies next steps. NOTE: This document is also available in the following formats: A Student Support Method to Attain School Quality Standards Using RtI as a Decision-Making Tool A Student Support Method to Attain School Quality Standards Using RtI as a Decision-Making Tool Documentation of RtI Implementation Plan Guidance In order to comply with Vermont Department of Education Special Education Regulation 2362.1(b)(1)(iii), the local educational agency (LEA) must submit documentation of intent to implement a problem solving, responsiveness to instruction model prior to the identification of students under the disability category of Specific Learning Disabilities (2362.1). Documentation must be submitted to Karin Edwards, Director of Student Support, Vermont Department of Education, 120 State Street, Montpelier, VT, 05620-2501 or e-mailed to karin.edwards@state.vt.us. View the key elements of RtI documentation. Worksheet Form for Documentation of Intent to Implement RtI       Special Education Evaluation & IEP Forms for 2007 The following links contain special education evaluation and individualized education program (IEP) forms with required notification letters. Users of these forms will be evaluating children age three through 21 years of age to determine their eligibility for special education services. Users will also use the individualized education program (IEP) form to develop a document of appropriate services, if the child is eligible.       The Special Education Evaluation and IEP forms 1-10 are available individually as Word files or as Rich Format Text (RTF) documents. The complete packet of forms may also be downloaded as a Word file or RTF document. Forms may be downloaded to a computer hard drive and completed using a word processing application:           Instructions to Special Education Forms  Word         Form 1: Notice of Meeting Word RTF             Form 2: Evaluation Plan and Report Word RTF             Form 3: Notice of a Special Education Evaluation Word RTF             Form 3(a): Consent for a Special Education Evaluation Word RTF             Form 4: Notice of Evaluation Delay Word RTF             Form 5: Individualized Education Program (IEP) Word RTF               Form 5(a): Written Agreement for Not Attending an IEP Meeting Word RTF               Form 5(b): Agreement to Revise the IEP Between Annual Review Meetings Word RTF             Form 6: Consent for Initial Provision of Special Education Services   Word RTF             Form 7: Notice of Local Educational Agency Refusal Word RTF               Form 7a: Notice of Local Educational Agency Decision Word RTF             Form 8: Written Agreement between Parents and District - Re-evaluations Word RTF               Form 9: Completion of an Evaluation of a Transfer Student Word RTF               Form 10: Written Affirmation of Consultation for Parentally Placed Private School School Students Word RTF                                 Complete Packet of Forms Word RTF         Laws & Regulations | Forms Data Reports & Publications | Policy & Administration General Resources | Parental Resources Special Education PDF files require the use of Adobe Acrobat Reader. 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