Special Education Evaluation Report - Vermont Agency
This file contains the Special Education Evaluation Report for a student named Mateo Velez. It includes details about the evaluation plan, team members involved, and assessment procedures used. The document is designed to determine the student's eligibility for special education services.
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How do I fill this out?
To fill out this form, start by providing the student's personal details, including name, date of birth, and current educational program. Next, document the evaluation plan, including the dates and methods used. Finally, complete the disability determination section, specifying the concerns and assessment methods used.

How to fill out the Special Education Evaluation Report - Vermont Agency?
1
Provide student's personal details.
2
Document the evaluation plan.
3
Specify the assessment methods.
4
Complete the disability determination section.
5
Submit the form to the appropriate agency.
Who needs the Special Education Evaluation Report - Vermont Agency?
1
Parents of a student who requires a special education evaluation.
2
Educators who need to document a student's special education evaluation plan.
3
School psychologists conducting assessments for special education eligibility.
4
Local Education Agency representatives overseeing special education evaluations.
5
Multilingual teachers concerned about a student's progress in reading fluency.
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What are the instructions for submitting this form?
Submit this form by mailing it to the Vermont Agency of Education, 1 National Life Drive, Davis 5, Montpelier, VT 05620-2501. You can also send it via fax to 802-828-6430 or email to the Special Education Monitoring Team. Ensure all required fields are completed and reviewed before submission for timely processing.
What are the important dates for this form in 2024 and 2025?
Referral: 09/20/2024, Planning Meeting: 10/3/2024, Received Consent: 10/3/2024, Report Completed: 11/10/2024, Eligibility Decision: 11/14/2024, Report Provided to Parent/Guardian: 11/14/2024.

What is the purpose of this form?
The purpose of this form is to document and evaluate a student's eligibility for special education services. It provides detailed information about the evaluation plan, assessment procedures, and team members involved in the process. This form ensures that all necessary steps are taken to determine if the student qualifies for special education services and helps create an appropriate educational plan.

Tell me about this form and its components and fields line-by-line.

- 1. Student Personal Details: Contains fields for student's name, date of birth, grade, and current educational program.
- 2. Evaluation Plan: Includes fields for referral date, planning meeting date, received consent date, report completion date, and eligibility decision date.
- 3. Evaluation and Planning Team Members: List of team members involved in the evaluation, including their names and roles.
- 4. Disability Determination: Fields to specify the suspected disability areas and concerns to evaluate, as well as assessment methods used.
What happens if I fail to submit this form?
Failure to submit this form may result in delays in the student's special education evaluation process. It is crucial to ensure timely submission to avoid any disruption in services.
- Delayed Evaluation: The evaluation process for special education services may be delayed.
- Interruption in Services: Failure to submit the form could lead to an interruption in the provision of necessary educational services.
- Lack of Documentation: Incomplete documentation may result in an inability to establish the student's eligibility for special education.
How do I know when to use this form?

- 1. Referral for Special Education: Use this form when a student is referred for a special education evaluation.
- 2. Documentation of Evaluation Plan: Use this form to document the evaluation plan and methods to be used.
- 3. Assessment of Specific Concerns: Utilize this form to specify the concerns and assessment methods for the evaluation.
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