Get the free section 504 referral - Swansea Public Schools

Section 504 Referral Form Student Name: Birthdate: School: Grade: Teacher(s): Referral Initiated By (and Title): Date: REASON FOR REFERRAL Suspected Physical or Mental Impairment Major Life Activity

How to fill out section 504 referral

How to fill out section 504 referral

1. To fill out the Section 504 referral form, follow these steps:
2. Start by gathering all relevant documents, such as student records, medical reports, and evaluation results.
3. Ensure that you have the necessary information about the student's disability or condition, including any functional limitations they may have.
4. Begin completing the referral form by providing the student's personal details, such as their name, age, grade level, and contact information.
5. Describe the student's disability or condition in detail, including any diagnoses or medical reports that support the referral.
6. Outline the specific functional limitations the student experiences as a result of their disability, and how these limitations affect their ability to participate in academic and non-academic activities.
7. Include information about any accommodations or services that have been provided to the student in the past, and their effectiveness.
8. If relevant, discuss any additional support or accommodations that you believe the student may need in order to fully access their education.
9. Review the completed referral form to ensure all necessary information is provided and that it is clear and concise.
10. Submit the referral form to the appropriate person or department, typically the school's designated Section 504 coordinator.
11. Keep a copy of the completed referral form for your records.

Who needs section 504 referral?

1. A section 504 referral is needed for students who have disabilities or conditions that substantially limit one or more major life activities.
2. This includes students who may have physical, mental, emotional, or learning disabilities.
3. The purpose of the referral is to ensure that these students receive appropriate accommodations and support to fully participate in their education.
4. Examples of students who may need a Section 504 referral include those with mobility impairments, chronic illnesses, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders, or specific learning disabilities.
5. The decision to initiate a Section 504 referral is typically made by school personnel, such as teachers, counselors, or administrators, based on observations, assessment results, and input from parents or guardians.
6. Ultimately, the goal is to identify students who may benefit from accommodations and services under Section 504 of the Rehabilitation Act of 1973.

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What is section 504 referral?

Section 504 referral is the process by which students with disabilities are referred for evaluation and eligibility for accommodations and services under Section 504 of the Rehabilitation Act of 1973.

Who is required to file section 504 referral?

School personnel, parents, or guardians can file a Section 504 referral for a student.

How to fill out section 504 referral?

To fill out a Section 504 referral, the person making the referral must provide relevant information about the student's disability and the need for accommodations or services.

What is the purpose of section 504 referral?

The purpose of a Section 504 referral is to ensure that students with disabilities have access to necessary accommodations and services to participate in education on an equal basis with their peers.

What information must be reported on section 504 referral?

Information to be reported on a Section 504 referral includes the student's disability, the impact of the disability on major life activities, and the need for specific accommodations or services.