******************************************************************************************************* School Age
Date:
|
Student Name |
|
DOB |
|
Name
and Address of Parent/Guardian:
Dear :
The
school district is planning to reevaluate your child for the following
reason(s):
The IEP team has reviewed existing
evaluation data concerning your child and made the recommendations that
there is a need for additional data. We
request your consent to conduct this reevaluation. Consent is needed before we can begin. However, please be aware that after reasonable attempts if we
have not received your response we are permitted by law to proceed with the
reevaluation. In the reevaluation, the
school district will review your child's educational needs and strengths (as
shown by educational performance levels, assessment results, classroom
observations, and information from you). Specific types of tests and procedures, which will be used in the
reevaluation, include the following:
The
reevaluation is proposed for the following date(s):
The school district will form a
multidisciplinary team to conduct the reevaluation. As parent(s), you are a member of the team. If a team meeting is held, you will be
invited. Information from you is to be
considered by the team as part of the reevaluation process. If you want to send written comments, please
do so.
The multidisciplinary team must determine whether the child
is a child with a disability and will prepare recommendations regarding your
child's educational program, and whether your child continues to be in need of
and eligible for special education and related services. This information will be outlined in an
Evaluation Report (ER) and will be given to the Individualized Education
Program (IEP) Team. The reevaluation
report is to be completed and a copy of the report is to be presented to the
parents no later than 60 school days after the agency receives written parental
consent to reevaluate.
Please call me at the number listed below to discuss
information that you feel is important to include in the reevaluation. Please read the enclosed Procedural
Safeguards Notice that includes parent resources such as state or local
advocacy organizations. If you have any questions, or if you need the services
of a translator or an interpreter, please contact me.
Name Position
Phone
|
Student Name |
|
DOB |
|
DIRECTIONS FOR PARENTS: Please check the
appropriate item(s), sign and return this form to the person below.
[ ] I consent to a reevaluation as you propose.
[ ] Please contact me. I am not ready to give consent for the
reevaluation at this time and would like to arrange an informal meeting to talk
about this.
[ ] I object to the proposed reevaluation; I
would like to schedule
[ ] Pre-hearing conference
[ ] Mediation
[ ] Due Process Hearing
School District
Contact:
* The enclosed Procedural Safeguards Notice
provides information on the options listed above.