Get the free Section 504 Referral Form I. Identifying Information Name

Student Counselling Referral Form (Please complete all sections)Date of this Referral: ___ Name of Person Making Referral: ___ Relationship to Student: ___ Name of Student: ___ Student Date of Birth:

How to fill out section 504 referral form

How to fill out section 504 referral form

1. Obtain a copy of the section 504 referral form from the school or district.
2. Fill out the student's personal information including name, date of birth, and contact information.
3. Provide information on the student's medical history, disabilities, and any accommodations or services they may need.
4. Include any relevant documentation such as medical reports, evaluations, or Individualized Education Plans (IEPs).
5. Sign and date the form, and ensure all required sections are completed before submitting it to the appropriate school staff.

Who needs section 504 referral form?

1. Students who have a disability or medical condition that requires accommodations or services to ensure equal access to education.

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What is section 504 referral form?

Section 504 referral form is a document used to refer students for evaluation and potential accommodations under Section 504 of the Rehabilitation Act of 1973.

Who is required to file section 504 referral form?

School staff, parents, or guardians may file a section 504 referral form for a student.

How to fill out section 504 referral form?

To fill out the form, provide information about the student's disability, impact on major life activities, and requested accommodations.

What is the purpose of section 504 referral form?

The purpose of the form is to ensure that students with disabilities receive appropriate accommodations to ensure equal access to education.

What information must be reported on section 504 referral form?

The form typically requires information about the student's disability, how it affects their ability to learn, and specific accommodations being requested.