Special Education Forms

The forms on this page guide educators and families through the IEP process, the General Supervision and Monitoring System processes and Proficiency-Based Graduation Requirements (PBGR). You will also find an Adverse Effect Chart and a Technical Assistance / Professional Development Request form to request support from the AOE in an area of need.


IEP Process and Evaluation Forms

Programs that opt to use these special education forms will be evaluating children age three through 21 years of age to determine their eligibility for special education services. Users will also use the individualized education program (IEP) form to develop a document of appropriate services, if the child is eligible.

IEP process and evaluation forms assist educators in all parts of the special education evaluation process. Each form is accompanied by instructions. They include:

  • Forms of NOTICE (1, 3, 4, 7, & 7a)
  • Forms CONSENT / AGREEMENT (3a, 5a, 5b, 6, 6a and 8)
  • Forms for WRITING and REVISING the IEP (5, & 5c)
  • Forms for EVALUATION (2 & 9)
  • A form for PARENTALLY PLACED students (10)
  • A form for TRANSITION from Preschool to K-12 (6b)

Form 1: Notice of Meeting​

      Instructions for Form 1


Form 2: Evaluation Plan and Report

      Instructions to Form 2


Form 3: Notice of A Special Education Evaluation

      Instructions to Form 3


Form 3a: Consent for A Special Education Evaluation

        Instructions to Form 3a


Form 4: Notice of An Evaluation Delay

      Instructions to Form 4


Form 5: Individualized Education Program (IEP)

      Instructions to Form 5


Form 5: Early Childhood Special Education (ECSE) Ages Three Through Five - Individualized Education
                   Program (IEP)


Form 5a: Written Agreement for Not Attending An IEP Meeting

         Instructions to Form 5a


Form 5b: Agreement to Revise the IEP Between Annual Review Meetings

         Instructions to Form 5b


Form 5c: Revision of the IEP Between Annual Review Meetings

         Instructions to Form 5c


Form 6: Consent for Initial Provision of Special Education

      Instructions to Form 6


Form 6a: Revocation of Consent for Provision of Special Education Services


Form 6b: Part C to Part B Transition (Consent for Initial Provision of Special Education) 

         Instructions to Form 6b


Form 7: Notice of Local Educational Agency Refusal

      Instructions to Form 7


Form 7a: Prior Written Notice of Decision

         Instructions to Form 7a - Notice of Local Education Agency Decision
         (Prior Written Notice of Decision)


Form 8: Written Agreement Between Parents and District Re-evaluations

      Instructions to Form 8


Form 9: Completion of An Evaluation of A Transfer Student

      Instructions to Form 9


Form 10: Written Affirmation of Consultation for Parentally Placed Private School Students

        Instructions to Form 10


General Supervision and Monitoring Forms

Monitoring Tools


Professional Development/Technical Assistance Request Form

Request Professional Development/Technical Assistance from the Agency of Vermont's Special Education Team.


Graduation / Proficiency-Based Graduation Requirement Forms

Proficiency-Based Graduation Requirements (PBGR) – Access Plan

Proficiency-Based Graduation Requirements (PBGR) – Access Plan (Blank Template) 


Back to Vermont Special Education Home

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Vermont Agency of Education
Secretary Daniel M. French
1 National Life Drive, Davis 5
Montpelier, VT 05620-2501

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Phone: (802) 828-1130 | Fax: (802) 828-6430
aoe.edinfo@vermont.gov
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