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Four Rivers Special Education District

    Forms

    IEP Meeting Forms

    • Illinois State Board of Education (ISBE) Forms (34-57 A-M)

    • Release of Information

    • Ten Day Waiver Notice

    • Medicaid Parental Consent Letter: English - Francois - Espanol

    • Medicaid Parental Consent for Billing - English - Francois - Espanol  

    • Notification of Conference

    EDC/IEP Checklists

    • EDC I IEP Checklist Instructions

    • EDC I IEP Checklist

    Student Data Forms

    • Student Data Coding  Sheet

    • Student Data Form Instructions

    • Student Data Input Form

    • Student Data Transition Form

    Referral Packets

    • Preschool Teacher Referral Packet

    • Referral Packet K-12

    Evaluation Forms

    • Social Development Form​

    • Health History Form

    • Medical Review

    504 Plans

    • 504 Plan

    • 504 Plan & Evaluation Consent Form

    Preschool Forms

    • Preschool Classroom Observation Request

    • Development Screening Student Information Form

    • Preschool Teacher Referral Packet​

    Student Observation Consent Form (K-12)

    • Student Observation Consent Form

    Mental Health Assessment Tools

    • Threat Assessment

    • Suicide Risk Assessment

    • Suicide Risk Assessment Procedure

    Staff Forms

    • Mileage Form

    Find Us

    Four Rivers Special Education District936 W. Michigan Ave.Jacksonville, IL 62650Phone: 217-245-7174Fax: 217-245-5533

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