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MASSAPEQUA PUBLIC SCHOOLS 504 PARENT REFERRAL FORMStudents Name: ___Date of Birth: ___School: ___Grade: ___Counselor/Psychologist: ___ Parent(s) Name: ___ Phone Number:___ Address:___ ___1. Describe
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How to fill out 504- parent referral form

How to fill out 504- parent referral form
01
Contact your child's school and request a 504- parent referral form.
02
Fill out the student's information section including name, grade, and date of birth.
03
Provide details about your child's disability or condition that requires accommodations.
04
Include any relevant medical or educational documentation to support your request.
05
Submit the completed form to the school's designated 504 coordinator for review.
Who needs 504- parent referral form?
01
Parents or guardians of students who have a disability or medical condition that requires accommodations in a school setting.
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What is 504- parent referral form?
504- parent referral form is a document used to request a Section 504 evaluation for a student who may have a disability that requires accommodations in the school setting.
Who is required to file 504- parent referral form?
Parents or legal guardians of a student who may need accommodations due to a disability are required to file 504- parent referral form.
How to fill out 504- parent referral form?
504- parent referral form can be filled out by providing the student's information, details about the disability or medical condition, and reasons for requesting accommodations.
What is the purpose of 504- parent referral form?
The purpose of 504- parent referral form is to start the process of evaluating a student for eligibility for accommodations under Section 504 of the Rehabilitation Act of 1973.
What information must be reported on 504- parent referral form?
The 504- parent referral form must include the student's name, age, grade level, relevant medical or disability information, and reasons for requesting accommodations.
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