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Section 504 Disciplinary Action Review Form (DARK)/ Manifestation Determination Review (MDR) Local Educational Agency Name Student Full NameDateSchoolDate of Birthmark(s)/Guardian(s)GradeAddressWVEIS
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A manifestation determination review sample is a process used in special education to assess whether a child's behavior that led to disciplinary action was a result of their disability.
The school district or educational institution is required to file a manifestation determination review when a student with an Individualized Education Program (IEP) is facing disciplinary actions.
To fill out a manifestation determination review sample, one must gather information on the student's behavior, review the IEP, and document the relationship between the behavior and the disability.
The purpose of the manifestation determination review sample is to ensure that students with disabilities are not unfairly punished for behaviors stemming from their disabilities.
The report must include details of the incident, the student's IEP, observations regarding the behavior, and whether the behavior was a manifestation of the student's disability.
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