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Sample Special Education Forms: I-3. IEP Student Cover Sheet 2025

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The document is a referral form for special education services for Heather Jones, a second-grade student in the Stevens Point School District. It outlines the initial evaluation process to determine if Heather has a disability affecting her educational performance, specifically noting her difficulties in reading, writing, and spelling. The referral includes information from teachers and medical assessments indicating signs of Attention Deficit Hyperactive Disorder and learning disabilities. The document details the steps for parental involvement, consent for evaluations, and the development of an Individualized Education Program (IEP) to address Heather's educational needs.

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