504 Forms

504 Document – Form – Description

504 Parent Guide Pamphlet

A 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.

B 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.

C 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.

D 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.

E 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.

F Section 504 Student Eligibility 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. It is also used at the conclusion of the evaluation to document the eligibility decision of the team. This form should be used at the initial eligibility determination and at each annual review.

G 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.

H 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.

I Section 504 Due Process Procedure This document describes the procedure for responding to a complaint of non-compliance. This form should always be distributed with the 504 Compliance Grievance Form (J) described below.

J 504 Compliance Grievance Form This document is completed by the family who is filing a complaint of non-compliance. This form should always be distributed with the Section 504 Due Process Procedure (I) described above.