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State Forms & Directions

Statewide Forms (NEW)

The new statewide forms will be posted in this location as they are finalized within ECATS. LEAs may begin the use of the new statewide forms in preparation for the implementation of ECATS or during the transition to ECATS beginning July 2018.

FORM NAMEDETAILSFORMEFFECTIVE DATE
ENGLISHSPANISHDIRECTIONS
Invitation to IEP Team Meeting Used for inviting the parent, guardian and/or student to IEP Team meetings  81kb 42kb  78kb April 17, 2018
Consent – Invitation of Outside Agencies for Transition Services Pre-K and Post-Secondary Transition  107kb 38kb 89kb April 17, 2018
Request to Excuse Required IEP Team Member(s) Can only be used for required IEP Team members if excused member provides input to the IEP Team in writing prior to the meeting or the excused member's area is not being discussed  97kb 128kb 79kb April 17, 2018
Special Education Referral – School Age Used when a disability is suspected for a school-age child 204kb 185kb 250kb April 25, 2018
Special Education Referral –
Pre-School
Used when a disability is suspected for a pre-school child 156kb 189kb    
Consent for Evaluation/Reevaluation Documents parental consent to conduct evaluations 98kb   50kb 136kb April 25, 2018 
ELIGIBILITY WORKSHEETS          
Autism Documents the results of the required screening and evaluations when Autism is suspected  53kb  79kb   May 16, 2018
Deaf-Blindness Documents the results of the required screening and evaluations when Deaf-Blindness is suspected  43kb  130kb   May 16, 2018
Deafness Documents the results of the required screening and evaluations when Deafness is suspected  40kb 128kb   May 16, 2018
Developmental Delay Documents the results of the required screening and evaluations when Developmental Delay is suspected  60kb  118kb   May 16, 2018
Emotional Disability Documents the results of the required screening and evaluations when Emotional Disability is suspected  79kb  133kb    May 23, 2018
Hearing Impairment Documents the results of the required screening and evaluations when Hearing Impairment is suspected  58kb 128kb    May 23, 2018 
Intellectual Disability Documents the results of the required screening and evaluations when Intellectual Disability is suspected  75kb  130kb    May 23, 2018 
Multiple Disabilities Documents the results of the required screening and evaluations when Multiple Disabilities are suspected  67kb  108kb    May 23, 2018 
Orthopedic Impairment Documents the results of the required screening and evaluations when Orthopedic Impairment is suspected  101kb 131kb    November 6, 2019
Other Health Impairment Documents the results of the required screening and evaluations when Other Health Impairment is suspected  103kb  108kb    November 6, 2019
Specific Learning Disability Documents the results of the required screening and evaluations when Specific Learning Disability is suspected  96kb  136kb    November 6, 2019
Speech or Language Impairment Documents the results of the required screening and evaluations when Speech or Language Impairment is suspected  126kb  131kb    November 6, 2019
Traumatic Brain Injury Documents the results of the required screening and evaluations when Traumatic Brain Injury is suspected  110kb 156kb    November 6, 2019
Visual Impairment (including Blindness) Documents the results of the required screening and evaluations when Visual Impairment is suspected  121kb  147kb    November 6, 2019
           
Eligibility Determination Documents the IEP Team's decision regarding whether or not a child is a child with a disability 123kb  58kb 220kb April 26, 2018
Individualized Education Program Documents the specially designed instruction and related services necessary to provide a child with a disability a free appropriate public education  294kb  213kb 472kb April 26, 2018
NC Communications Plan Worksheet Documents the communication used and/or necessary for students who are deaf or hard of hearing  147kb  77kb    November 6, 2019
Extended School Year (ESY) Worksheet Documents the factors considered when determining extended school year for a child with a disability 99kb 30kb    
Prior Written Notice Documents the final decisions of the IEP Team  160kb 76kb  87kb April 26, 2018
Consent for Services Documents the initial consent for the provision of special education and related services 22kb 23kb 57kb April 26, 2018
Private School Services Plan Documents the special education services made available to a child with a disability that has been parentally placed in private school 172kb  200kb   February 18, 2020
Disciplinary Change in Placement Notice of a disciplinary change in placement 122kb  156kb   February 18, 2020
Manifestation Determination Documents whether or not a disciplinary change in placement is a manifestation of a child's disability 142kb  160kb   February 18, 2020
Secondary Transition – Summary of Performance Summary of the child's academic achievement and functional performance, which includes recommendations on how to assist the child in meeting the child's postsecondary goals.  109kb  116kb    
Reevaluation Documents the IEP Team's review of existing data and whether or not additional data are needed to determine if a child is still a child with a disability and specially designed instruction and related services  116kb  89kb 82kb  April 26, 2018
SUPPLEMENTAL FORMS          
Consent for Release of Contact Information to Residential Schools for the Deaf and Blind (HB 1030) Requires North Carolina public schools to provide a consent for release of information form to parents, guardians, or custodians of students identified with a primary disability of hearing and/or vision loss, or if the student is identified as multiple disabled and has hearing and/or vision loss.      
Worksheet: Students with Specific Learning Disabilities and Mathematics Sequence Exemption for High School Graduation (NC General Statute 115C-81b) This is a guide to assist IEP Teams in determining whether or not a math sequence exemption is appropriate for a child with a disability.  180.8kb
199kb
   

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