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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 form

How to fill out section 504 referral form

1. To fill out a Section 504 referral form, follow these steps:
2. Start by gathering all the necessary information about the student, including their name, date of birth, and contact information.
3. Identify the reason for the referral and clearly explain the student's condition or disability that requires accommodation under Section 504.
4. Provide details about the student's academic performance and any limitations or challenges they may face in the educational setting.
5. Include any supporting documentation, such as medical records, psychological evaluations, or previous accommodation plans.
6. Specify the types of accommodations or services that are being requested for the student.
7. Fill in the referral form completely, ensuring accuracy and completeness of all the provided information.
8. Review the form for any errors or missing information before submitting it.
9. Submit the completed form to the appropriate school official or committee responsible for Section 504 accommodations.
10. Keep a copy of the filled-out form for your records.
11. Follow up with the school to inquire about the status of the referral and any further steps that need to be taken.

Who needs section 504 referral form?

1. The Section 504 referral form is needed by any student who has a disability or condition that may require accommodations or services under Section 504 of the Rehabilitation Act of 1973.
2. This includes students who may have physical or mental impairments that substantially limit one or more major life activities, such as learning, walking, seeing, hearing, or self-care.
3. The form is typically used by parents, guardians, or school personnel to initiate the process of evaluating the student's eligibility for Section 504 accommodations.

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What is section 504 referral form?

The Section 504 referral form is a document used to initiate the process of evaluation for students who may need accommodations or modifications under Section 504 of the Rehabilitation Act of 1973.

Who is required to file section 504 referral form?

Typically, the referral form can be filed by teachers, parents, or guardians, and sometimes school staff or administrators if they observe that a student may need support.

How to fill out section 504 referral form?

To fill out the Section 504 referral form, one must provide detailed information about the student's educational history, observed behaviors, any existing evaluations, and specific concerns that warrant the evaluation.

What is the purpose of section 504 referral form?

The purpose of the Section 504 referral form is to formally begin the assessment process for students who may require accommodations due to disabilities that impact their learning.

What information must be reported on section 504 referral form?

The form typically requires information such as the student's personal details, specific observations and concerns about their academic performance, previous interventions, and any documented disabilities.