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Section 504 Referral Form 4, page 1 of 4 Section 504 Referral (Attach extra pages as necessary) Student: Student ID #: Date of Birth: Grade: Referral Date: Campus: Referred by: Position/Relation to

How to fill out section 504 referral

How to Fill Out Section 504 Referral:

1. Begin by gathering all necessary information about the individual in question, such as their name, date of birth, and current school or educational institution.
2. Clearly state the reason for the section 504 referral, detailing the specific limitations or impairments that the individual may have in order to qualify for accommodations or services under Section 504.
3. Provide a thorough description of the individual's needs and challenges, including any medical or psychological diagnoses that may impact their ability to fully participate in educational activities.
4. Include relevant documentation, such as medical records, evaluations, or assessments that support the need for accommodations or services.
5. Specify the desired accommodations or services that the individual may require to ensure equal educational opportunities, such as extended time for exams, preferential seating, assistive technology, or specialized instruction.
6. Provide contact information for the referring person - this could be a teacher, parent, or school administrator - so that further communication or clarification can be made if necessary.
7. Double-check all information and ensure that the referral is complete before submitting it to the appropriate individual or department at the school or educational institution.

Who Needs Section 504 Referral:

1. Students or individuals with disabilities who may require accommodations or services to participate fully in educational activities. This can include individuals with physical, mental, sensory, or emotional impairments that substantially limit one or more major life activities, such as learning, walking, seeing, hearing, or caring for oneself.
2. Individuals who have a record of such impairments. This means that even if a person no longer has a current disability, they may still qualify for accommodations or services if they have a history of impairment that substantially limited major life activities.
3. Individuals who are regarded as having such impairments. This means that even if someone does not have an actual disability, they may still be perceived as having one and therefore qualify for accommodations or services under Section 504.

In summary, filling out a Section 504 referral involves providing detailed information about the individual's needs and challenges, including supporting documentation and desired accommodations or services. Section 504 referrals are needed by students or individuals with disabilities, those with a history of impairments, or individuals who are perceived as having impairments.

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What is section 504 referral?

Section 504 referral is a process where individuals with disabilities can request accommodations or modifications to have equal access to programs and activities.

Who is required to file section 504 referral?

Parents, teachers, or school administrators are typically responsible for filing a section 504 referral for a student.

How to fill out section 504 referral?

Section 504 referral forms can be obtained from the school's office or website, and then must be completed with detailed information about the student's disability and requested accommodations.

What is the purpose of section 504 referral?

The purpose of section 504 referral is to ensure that individuals with disabilities have equal access to educational programs, services, and activities.

What information must be reported on section 504 referral?

Section 504 referral forms typically require information about the student's disability, recommended accommodations, and any supporting documentation.