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SAU88 Lebanon School District SECTION 504 REFERRAL FORM Date of Birth:Student: School:Teacher: Grade:Counselor:1. Identify who is making this referral and, if not the parent, has the parent been informed:2.
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How to fill out section 504 referral form

How to fill out section 504 referral form
01
Obtain a section 504 referral form from your school or educational institution.
02
Read the instructions and understand the purpose and requirements of the form.
03
Fill in the personal information section, including the student's name, date of birth, and contact information.
04
Provide relevant details about the student's disability or impairment in the designated section.
05
Describe how the disability or impairment affects the student's ability to access educational programs and services.
06
Include any supporting documentation or medical reports that may be required to demonstrate the need for a section 504 evaluation.
07
Follow any additional guidelines or instructions provided by your school or educational institution.
08
Review the completed form for accuracy and completeness.
09
Submit the section 504 referral form to the appropriate authority or department at your school or educational institution.
10
Keep a copy of the completed form for your records.
Who needs section 504 referral form?
01
Individuals who believe they or someone they know may have a disability or impairment that affects their ability to access educational programs and services may need to fill out a section 504 referral form. This form is typically used in schools and educational institutions to initiate an evaluation process to determine if the individual qualifies for accommodations or support under section 504 of the Rehabilitation Act.
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What is section 504 referral form?
The Section 504 referral form is a document used to request an evaluation for students who may require special accommodations due to disabilities under Section 504 of the Rehabilitation Act of 1973.
Who is required to file section 504 referral form?
The referral form can be filed by parents, teachers, or school staff who believe a student may have a disability that requires accommodations.
How to fill out section 504 referral form?
To fill out the Section 504 referral form, provide the student's personal information, describe the suspected disability, outline the observed behaviors or challenges, and include any relevant documentation or assessments.
What is the purpose of section 504 referral form?
The purpose of the Section 504 referral form is to initiate the evaluation process to determine if a student qualifies for accommodations and services based on a disability.
What information must be reported on section 504 referral form?
The form must report the student's name, date of birth, a description of the disability, relevant educational history, behaviors or issues observed, and any previous interventions or assessments conducted.
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