Elementary

Junior High

High School

Alternative


Special Education Fillable Forms


 

Behavior & LRBI

Functional Behavioral Assessment and Behavior Intervention Plan Resources and Forms

Least Restrictive Behavior Initiative (LRBI)

Emergency Contact

Manifestation Determination

Transportation and Bus Safety for Students with Disabilities

Data Collection

Retrieved June 2017 from Ben Springer, Ph.D., NCSP at UMTSS conference

Web Based Resources


ABC Observation Forms


Data Collection Forms and Tools


Excel Goal Tracker Data Sheets

Evaluation & Eligibility Resources

Extended Year Legislative Days

Extended Year Additional Pay for Special Educators

Explanation of Extended Year Options - updated 7-31-18 (.pdf)

USBE's Extended Year for Special Educators (R-277-525) for SPED teachers, Vision Specialists, Hearing Specialists, Adapted PE Teachers and SLPs ONLY.

Davis School District's "Extended Year Contract" for School Psychologists, Audiologists, OT and PT ONLY

DSD Extended Year Record of Work Completed for School Psychologists, Audiologists, OT and PT ONLY (.pdf - fillable & savable in adobe reader) Sample Extended Year Time Card for School Psychologists, Audiologists, OTs and PTs ONLY.

Eligible work days:

  • August 3-16, 2018
  • June 3-14, 2019

Extended School Year (ESY)

File Compliance & File Transfer

Health Care & Medical Information

Health and Medical Information


Authorization and Release of Health Information (.pdf)

Child Health and Developmental History

Health Professional Report - The Health Professional Report supports teams in gathering the required medical history information. This form is NOT mandatory. A medical history might also be documented as a medical report and an evaluation summary from a private clinical setting. If there is documentation of prior medical history, specific syndromes (if applicable), health concerns and medications, the name and role of the medical provider and the date, it is a medical history.

See the Policy and Information Exchange (PIE) website for the Medical History Definition and Procedures (PIE folder log-in required)

Special Education Nurses' Forms

IEP Accommodations & Progress Reports

IEP Accommodations, Participation in State and Local Assessment
and IEP Progress Report Forms

Meeting Documents

Meeting Documents


Meeting Summary Options

Parental Procedural Safeguards

Procedural Safeguards Summary
Procedural Safeguards Document (updated November 2016)

  • Spanish (2016 version)
  • USBE Versions - Procedural Safeguards and Annual Parent/Guardian Notices (Child Find, Carson Smith Special Needs Scholarship, Destruction of Records, Medicaid Information) for Students with Disabilities and their Parents under the IDEA 2004. -- Revised November 2016 -- Translations for Navajo, Arabic, Somali, Spanish, Tongan, and Vietnamese are all available here. When you get to the page, click the sub tab entitled "Procedural Safeguards"

Other Documents

Anecdotal Record (Not to be used as a meeting summary document.)

Off-Campus Community Access

Off Campus Community Access:


Support Team Referrals

Support Teams and Other Referrals


Support Teams

Davis District Special Education Support Team Wraparound Referral 2-1-18 - This survey is to gather student information to best meet the needs of the student and the referring team. Please take the time to complete the entire form. After completion of the form, you should be contacted by a Support Team member within one week. (for Autism, BEST,Brain Injury Team and Inclusion Team Referrals)

Davis Assistive Technology Team - D.A.T.T Referral Process

Support Team Webpage

Other Referrals

Adapted PE Referral
Occupational Therapy Referral - Please contact the OT that serves your school for support.
Physical Therapy Referral

Transition & Graduation

Transition and Graduation