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SameGoal includes forms, validation rules and reports for Special Education and Section 504.

SPECIAL EDUCATION link

Includes Sample Special Education Forms published by DPI Special Education.

Evaluation Forms/Notices

Form NoForm NameLink
R-1Referral For Special Education and Related ServicesLink
IE-1Notice of Receipt of Referral and Start of Initial EvaluationLink
IE-2Initial Evaluation: Notice that No Additional Assessments NeededLink
IE-3Initial Evaluation: Notice and Consent Regarding Need to Conduct Additional AssessmentsLink
RE-1Notice of ReevaluationLink
RE-2Notice of Agreement to Conduct a Reevaluation More Than Once a YearLink
RE-3Notice of Agreement That a Three-Year Reevaluation Not NeededLink
RE-4Reevaluation: Notice That No Additional Assessments NeededLink
RE-5Reevaluation: Notice and Consent Regarding Need to Conduct Additional AssessmentsLink
ER-4Notice of IEP Team Findings That Child is Not a Child With a DisabilityLink
ED-1Existing Data Review to Determine if Additional Assessments or Evaluation Materials Are NeededLink

Evaluation Report Sections include

Form NoForm NameLink
I-3IEP Team Meeting Cover PageLink
ER-1Evaluation Report, including Determination of Eligibility and Need for Special EducationLink
ER-2ARequired Documentation for Specific Learning Disability (SLD) - Initial EvaluationLink
ER-2BRequired Documentation for Specific Learning Disability (SLD) - ReevaluationLink
ER-2CRequired Documentation for Specific Learning Disability (SLD) - Initial Evaluation Using Significant DiscrepancyLink
ER-3Documentation for Determining Braille Needs for a Child With a Visual ImpairmentLink

Eligibility Checklists

Form NoForm NameLink
ELD-AUT-001AutismLink
ELG-ID-001Intellectual DisabilityLink
ELG-DHH-001Hearing ImpairmentLink
ELG-VIS-001Visual ImpairmentLink
ELG-EBD-001Emotional Behavior DisabilityLink
ELG-OI-001Orthopedic ImpairmentLink
ELG-OHI-001Other Health ImpairedLink
ELG-SPL-001Speech/Language ImpairmentsLink
ELG-SDD-001Significant Development DelayLink
ELG-TBI-001Traumatic Brain InjuryLink

IEP Forms/Notices

Form NoForm NameLink
I-1Invitation To a Meeting of the Individualized Education Program (IEP) TeamLink
I-1-ARequest to Invite Outside Agency Representative(s) to the IEP MeetingLink
I-1-BRequest to Invite Birth to 3 Program Representative(s) to the Initial Individualized Education Program (IEP) MeetingLink
I-1-CRequest to Invite Others with Knowledge or Special Expertise to an Individualized Education Program (IEP) MeetingLink
I-2Agreement on IEP Team Participant Attendance at IEP MeetingLink
I-10Notice of Changes to IEP Without an IEP Team MeetingLink
I-12Manifestation Determination ReviewLink
DW-1Worksheet for Documenting Educational Services Provided During Disciplinary Removals that Do Not Constitute a Disciplinary Change of PlacementLink

Individualized Education Plan Sections include

Form NoForm NameLink
I-3IEP Team Meeting Cover PageLink
I-4Linking Present Levels, Needs, Goals, and Services FormLink
I-5Annual Review of IEP GoalsLink
I-6Interim Review of IEP GoalsLink
I-7-AParticipation Guidelines for Alternate AssessmentLink
I-7-ACCESS for ELLs/ Alt. Access for ELLsParticipation in Statewide English Language Proficiency Assessment Checklist and AccommodationsLink
I-7-ACT Plus WritingParticipation in Statewide Assessments (ACT PLUS Writing)Link
I-7-Aspire Early High SchoolParticipation in Statewide Assessments (ACT Aspire Early High School)Link
I-7-District-Wide AssessmentParticipation in Districtwide AssessmentsLink
I-7-DLMParticipation in Statewide Assessments (Dynamic Learning Maps)Link
I-7-ForwardParticipation in Statewide Assessments (Forward Exam)Link
I-8Postsecondary Transition Plan WorksheetLink
I-11Extended School YearLink

Additional Forms/Notices

Form NoForm NameLink
P-1Determination and Notice of Placement: Consent for Initial PlacementLink
P-2Determination and Notice of PlacementLink
P-3Notice of GraduationLink
P-4Notice of Ending of Services Due to AgeLink
P-5Parent Revocation of Consent for Special EducationLink
P-6Notice of Cessation of Special Education and Related Services in Response to Parental Revocation of ConsentLink
M-1Notice of Response to an Activity Requested by a ParentLink
M-2Notice of Agreement to Extend Time Limit to Complete Evaluation for Transfer StudentLink
M-3Agreement to Extend the Time Limit to Complete the Evaluation of a Child Suspected of Having a Specific Learning DisabilityLink
M-5Consent to Bill Wisconsin Medicaid for Health-Related Special Education and Related ServicesLink
M-6Notification of Upcoming Transfer of RightsLink
M-7Student Notification of Transfer of RightsLink
M-8Parent Notification of Transfer of RightsLink
EE-1Data Worksheet for Determining Environment CodesNA
SoPSummary of PerformanceNA
NAProgress Report (autogenerated from IEP)NA
NAIEP at a Glance (autogenerated from IEP)NA
NADaily Feedback Feedback Sheet (autogenerated from IEP)NA

SECTION 504 link

Includes 504 forms used widely in Wisconsin.

Form Name
Referral Form
Notice of Initial Evaluation or Reevaluation
Notice and Consent for Initial Placement
Notice of Continuing Placement
Notice of Manifestation Determination Review
Consent for Additional Testing
No Additional Testing Needed
Invitation to Section 504 Meeting
Evaluation Meeting Report and Determination of Eligibility
Individual Accommodation Plan (IAP)


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