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Section 504/ADA

 
 
SECTION 504/American Disability Act (ADA)
 
Donna LeFevre
Section 504 Coordinator

25 Quality Street
Munfordville, KY 42765

PHONE: 270-524-9345
FAX: 270-524-2634

donna.lefevre@hart.kyschools.us
FORM LIST for Referral Meeting:
Section 504 Forms


A Guide to Section 504 Forms...

 

FORM LIST for Referral Meeting:
--- Notice of Meeting (send home at least 7 calendar days prior to meeting date)
--- Documentation of Contact (in conjunction with "Notice of Meeting" - listed above)

--- Parent Rights (send copy home & have copy at meeting)
--- Meeting Summary (complete at meeting)
--- Student Referral (complete as much as possible prior to meeting; finish at meeting)
--- Eligibility Evaluation (this is the consent for the evaluation)
--- Health Care Provider Questionnaire (send by parent to physician after meeting - parent to return to personnal ASAP) 

--- Release of Information - HIPPA (Medical Release) - (found on website; complete at meeting and obtain parent signature ONLY if parent wants school to obtain a completed Health Care Provider Questionnaire - see document above)



FORM LIST for Evaluation Results/Eligibility Review Meeting:
(to be used for review of results at BOTH an initial evaluation AND a three-year reevaluation meeting)
--- Notice of Meeting (send home at least 7 calendar days prior to meeting date)
--- Documentation of Contact (in conjunction with "Notice of Meeting" - listed above)

--- Parent Rights (have copy at meeting)
--- Meeting Summary (complete at meeting)
--- Evaluation Summary (person completing this shall provide a copy)
--- Eligibility Determination (complete at meeting as a committee)
--- Notice of Eligibility Determination (complete and send home to guardian ONLY if guardian did not attend meeting)

--- Accommodation Plan (in case student qualifies; to be completed at meeting; may bring rough draft)
--- Consent for Implementation (if qualified for placement)



FORM LIST for Annual Review Meeting:
(Annual Review Meetings for reviewing & developing Accomodation Plan minimum yearly basis to the last
date for students already identified & placed in the Section 504 Program)

--- Notice of Meeting (send home at least 7 calendar days prior to meeting date)
--- Documentation of Contact (in conjuntion with "Notice of Meeting" - listed above)
--- Parent Rights (have copy at meeting)
--- Meeting Summary (complete at meeting)
--- Accommodation Plan (to be completed at meeting; may bring rough draft)
--- Consent for Implementation (for continuination of Accommodation Plan)



FORM LIST for Three-Year Reevaluation Meeting:
(Three-Year Reevaluation Meetings for reviewing (always), retesting (if applicable), & redetermining eligibility (always) occur at a minimum of every 3 years to the last date for students already identified & placed in the Section 504 Program)
--- Notice of Meeting (send home at least 7 calendar days prior to meeting date)
--- Documentation of Contact (in conjunction with "Notice of Meeting" - listed above)
--- Parent Rights (have copy at meeting)
--- Meeting Summary (complete at meeting)
--- Eligibility Evaluation (this is the consent for the evaluation)
--- Health Care Provider Questionnaire (send by parent to physciian after meeting - parent to return to personnel ASAP)
--- Release of Information - HIPPA (Medical Release) -  (found on website; complete at meeting and obtain parent signature ONLY if parent wants school to obtain a completed Health Care Provider Questionnaire - see document above



FORM LIST for Disciplinary Meeting:
--- Notice of Meeting (send home at least 7 calendar days prior to meeting date)
--- Documentation of Contact (in conjunction with "Notice of Meeting" - listed above)
--- Parent Rights (have copy at meeting)
--- Meeting Summary (complete at meeting)
--- Impartial Hearing (have copy at meeting for parent and committee if needed)
--- Manifestation Determination (complete at meeting)
--- Accommodation Plan (bring current plan and new blank form so that old can be reviewed AND a new one can be written if needed to help address behavioral issues - blank form will not necessarily be utilized)
--- Consent for Implementation (for continuation of Accommodation Plan)





--- RECOMMENDATION: It is recommended that you locate two additional pieces of paperwork found in Infinite Campus (Functional Behavioral Assessment [FBA] & Behavioral Intervention Plan [BIP]) - personnel from special education department can assist with locating these as both should be completed for any student with behavioral concerns.

 

Additional Info

(11-17-16 update)

FORMS:

AccommodationPlan
 
(use Form 10 only when guardian did not attend meeting)

 

Click HERE to link directly to the Hart County School District - Special Education Website to obtain a copy of the "Release of Information - HIPPA" that is required to be sent with physician questionnaires (document is listed on the right side of the page under FORMS (subsection DUE PROCESS FORMS) - 11th document). Click directly on the document name on the Special Education Website to open the form for printing.

Contact Us

Hart County Schools
25 Quality Street
Munfordville, KY 42765

View Map & Directions
Phone: 270-524-2631

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