Skip to content. | Skip to navigation

Personal tools
Log in

Navigation

You are here: Home / Policies / Forms / State Forms & Directions

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    78kb April 17, 2018
Consent – Invitation of Outside Agencies for Transition Services Pre-K and Post-Secondary Transition  107kb    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    79kb April 17, 2018
Special Education Referral – School Age Used when a disability is suspected for a school-age child 204kb   250kb April 25, 2018
Special Education Referral –
Pre-School
Used when a disability is suspected for a pre-school child        
Consent for Evaluation/Reevaluation Documents parental consent to conduct evaluations 98kb    136kb April 25, 2018 
ELIGIBILITY WORKSHEETS          
Autism Documents the results of the required screening and evaluations when Autism is suspected  53kb     May 16, 2018
Deaf-Blindness Documents the results of the required screening and evaluations when Deaf-Blindness is suspected  43kb     May 16, 2018
Deafness Documents the results of the required screening and evaluations when Deafness is suspected  40kb     May 16, 2018
Developmental Delay Documents the results of the required screening and evaluations when Developmental Delay is suspected  60kb     May 16, 2018
Emotional Disability Documents the results of the required screening and evaluations when Emotional Disability is suspected  79kb      May 23, 2018
Hearing Impairment Documents the results of the required screening and evaluations when Hearing Impairment is suspected  58kb      May 23, 2018 
Intellectual Disability Documents the results of the required screening and evaluations when Intellectual Disability is suspected  75kb      May 23, 2018 
Multiple Disabilities Documents the results of the required screening and evaluations when Multiple Disabilities are suspected  67kb      May 23, 2018 
Orthopedic Impairment Documents the results of the required screening and evaluations when Orthopedic Impairment is suspected        
Other Health Impairment Documents the results of the required screening and evaluations when Other Health Impairment is suspected        
Specific Learning Disability Documents the results of the required screening and evaluations when Specific Learning Disability is suspected        
Speech or Language Impairment Documents the results of the required screening and evaluations when Speech or Language Impairment is suspected        
Traumatic Brain Injury Documents the results of the required screening and evaluations when Traumatic Brain Injury is suspected        
Visual Impairment (including Blindness) Documents the results of the required screening and evaluations when Visual Impairment is suspected        
           
Eligibility Determination Documents the IEP Team's decision regarding whether or not a child is a child with a disability  180kb   220kb April 25, 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  302kb   472kb  April 26, 2018
NC Communications Plan Worksheet Documents the communication used and/or necessary for students who are deaf or hard of hearing        
Extended School Year (ESY) Worksheet Documents the factors considered when determining extended school year for a child with a disability        
Prior Written Notice Documents the final decisions of the IEP Team  91kb   87kb  April 26, 2018
Consent for Services Documents the initial consent for the provision of special education and related services  76kb   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        
Disciplinary Change in Placement Notice of a disciplinary change in placement        
Manifestation Determination Documents whether or not a disciplinary change in placement is a manifestation of a child's disability        
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.        
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   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.        

Document Actions