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MERRIMACK SCHOOL DISTRICT36 McIlwain Street, Merrimack, New Hampshire 03054SECTION 504 REFERRAL FORM Student Name:Referral Date:School: Choose a School from the drop-down:Grade:Parent/Guardian:Address:Choose
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How to fill out section 504 referral form
How to fill out section 504 referral form
01
Obtain a copy of the Section 504 referral form from your school's administration or website.
02
Fill out the student's personal information such as name, date of birth, and contact information.
03
Provide a detailed description of the student's disability or medical condition that may require accommodations.
04
Include any relevant medical documentation or reports to support the referral.
05
Sign and date the form, indicating your consent for the evaluation to take place.
Who needs section 504 referral form?
01
Students who have a disability or medical condition that may require accommodations in school.
02
Parents or guardians who believe their child may benefit from Section 504 accommodations.
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What is section 504 referral form?
Section 504 referral form is a document used to refer a student for a Section 504 evaluation to determine if they have a disability that requires accommodations in the educational setting.
Who is required to file section 504 referral form?
School personnel, parents, or guardians can initiate the process of filing a Section 504 referral form.
How to fill out section 504 referral form?
To fill out a Section 504 referral form, all relevant information about the student's disability and need for accommodations must be provided.
What is the purpose of section 504 referral form?
The purpose of a Section 504 referral form is to identify students who may have disabilities that require accommodations under Section 504 of the Rehabilitation Act of 1973.
What information must be reported on section 504 referral form?
The Section 504 referral form must include information about the student's disability, the impact of the disability on their educational performance, and the specific accommodations being requested.
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