List of FCPS Forms to Search Search the forms that FCPS provides across various programs and departments. FCPS Forms and Documents Search Displaying 201 - 250 of 307 results IT 2: Student Withdrawal Used by schools to document the withdrawal of a student from FCPS PDF iconit2 IT 9: Former Student Records Request Used by FCPS alumni to request student records. PDF iconEnglish (English) Korean 2023-24 K-8 Privacy Opt-Out Forms Korean version of the Complete K-8 Annual Notice of Survey, Records, Curriculum, Privacy, and Related Rights and Opt-Out Forms booklets. PDF icon한국어 (Korean) Korean 2023-24 One-Page Privacy Opt-Out Flyer Korean version of the 2023-24 One-Page Privacy Opt-Out Flyer. PDF icon한국어 (Korean) MCH 213: School Entrance Physical Examination Health Information Form/Comprehensive Physical Examination Report/Certification of Immunization PDF iconEnglish (English) Office of Food and Nutrition Services Civil Rights Complaint Procedure and Form PDF iconOffice of Food and Nutrition Services Civil Rights Complaint Procedure and Form Retiree Tax Forms PDF iconIRS W-4P Federal Tax Withholding Form PDF iconVA-4P State Tax Withholding Form S 011: Fraud, Waste & Abuse Reporting Used to report fraud, waste, or abuse to the Office of the Auditor General. PDF iconEnglish (English) S 020: Student Concussion Evaluation Used to facilitate communication between medical professionals and school staff regarding academic supports for students recovering from a concussion. PDF iconEnglish (English) S 023: Thomas Jefferson High School for Science and Technology (TJHSST) Transcript Request Form for Current Students Used by TJHSST to request student transcripts. PDF iconEnglish (English) SB 102: School Board Audit Committee Membership Application This form is used by those in the Fairfax community interested in applying to serve on the School Board Audit Committee. PDF iconEnglish (English) SE 55: FCPS Advisory Committee for Students with Disabilities (ACSD) Public Interest Form Used by community members, parents, and staff to indicate interest in membership on the ACSD. PDF iconEnglish (English) Spanish 2023-24 One-Page Privacy Opt-Out Flyer Spanish version of the 2023-24 One-Page Privacy Opt-Out Flyer. PDF iconespañol (Spanish) SS/SE 10: Special Education Eligibility Form Used by special education staff to conduct a special education services eligibility for a student. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 107: Parent Notice of Eligibility Determination Used by special education staff to notify parents if a student is eligible for special education services. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10A: Autism Basis for Committee Decision Used by special education staff to show basis for decision - autism. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10B: Emotional Disability Basis for Committee Decision Used by special education staff to show basis for decision - emotional disability. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10C: Hearing Impairment Basis for Committee Decision Used by special education staff to show basis for decision - hearing impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10D: Intellectual Disability Basis for Committee Decision Used by special education staff to show basis for decision - intellectual disabilities. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10E: Multiple Disabilities Basis for Committee Decision Used by special education staff to show basis for decision - multiple disabilities. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10F: Orthopedic Impairment Basis for Committee Decision Used by special education staff to show basis for decision - orthopedic impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10G: Other Health Impairment Basis for Committee Decision Used by special education staff to show basis for decision - other health impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10I: Specific Learning Disability Basis for Committee Decision Used by special education staff to show basis for decision - specific learning disability. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10J: Speech/Language Impairment Basis for Committee Decision Used by special education staff to show basis for decision - speech and language impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF iconespañol (Spanish) PDF icon한국어 (Korean) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10K: Traumatic Brain Injury Basis for Committee Decision Used by special education staff to show basis for decision - traumatic brain injury. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10L: Visual Impairment Basis for Committee Decision Used by special education staff to show basis for decision - visual impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10M: Developmental Delay Basis for Committee Decision Used by special education staff to show basis for decision - developmental delay. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10N: Deafness Basis for Committee Decision Used by special education staff to show basis for decision - deafness. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 10P: Deaf-Blindness Basis for Committee Decision Used by special education staff to show basis for decision - deaf/blindness. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 119: Request For Pass-Fail Status Used by FCPS students to request to take a class as pass/fail. PDF iconEnglish (English) SS/SE 126: Notice of Reevaluation Used by special education staff to conduct a reevaluation of a student. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 127: Parent Information Used by parents to share information with their student's school. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 128: Unilateral Withdrawal from FCPS Used by special education staff to confirm unilateral withdrawal of student from FCPS. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 13: Notice Not to Evaluate Used by special education staff to notify parents their student will not be evaluated for services. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 14: Local Screening Committee Report Used by the local screening committee to report on a student receiving services. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 141: Prior Written Notice Used by special education staff to provide prior notice to parents of FCPS refusal for the placement of their child. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) SS/SE 142: Notice of Eligibility Meeting Used by special education staff to provide notice to the parents of an eligibility meeting. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 180: Specific Health Care Procedures Authorization Used by school staff to obtain permission for specific medical procedures for a student. PDF iconEnglish (English) SS/SE 180A: Specific Health Care Procedures Authorization for G-Tube Feeding Used by parents to obtain healthcare provider authorization of specific orders for students requiring G-tube feedings during school. PDF iconEnglish (English) SS/SE 2: Notice and Consent for Evaluation Used by special education staff to give notice to as well as get consent from parents to conduct a special education evaluation. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 200: Physician’s Referral for Participation in Physical Education Used to obtain a physician's request to modify a student's participation in PE. PDF iconse200 SS/SE 215: Request for Wavier of Full-Day Schedule Requirement Used to obtain permission by FCPS for a student to attend less than a full day. PDF iconEnglish (English) SS/SE 217: Functional Behavior Assessment (Draft) Draft version of the form used by school staff to conduct a functional behavioral assessment. PDF iconEnglish (English) SS/SE 218: Behavior Intervention Plan (Draft) Draft version of the form used by school staff to create a functional behavioral plan. PDF iconEnglish (English) SS/SE 218A: Behavior Intervention Plan Review (Draft) Draft version of the form used by school staff to review a functional behavioral plan. PDF iconEnglish (English) SS/SE 219: Criminal Conviction and Juvenile Delinquency Adjudication Affirmation Used by parents to affirm their student has not been adjudicated for a crime. PDF iconse219 SS/SE 228: Pre-Kindergarten Experience Used by parents to indicate their student's pre-k experience. Used for statistical purposes only. PDF iconse228 SS/SE 251: Eligibility Committee Additional Data Required Used by special education staff to obtain additional data for eligibility meetings. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 264: Emergency Use of Physical Restraint & Seclusion (Incident Documentation) Used by school staff to document emergency use of physical restraint. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) SS/SE 266: Parent Consent for Individualized Screening and Consultation Used to obtain parental consent for individual screening and consultation. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) First Previous1234 Currently on page 5 67Next Last
IT 2: Student Withdrawal Used by schools to document the withdrawal of a student from FCPS PDF iconit2
IT 9: Former Student Records Request Used by FCPS alumni to request student records. PDF iconEnglish (English)
Korean 2023-24 K-8 Privacy Opt-Out Forms Korean version of the Complete K-8 Annual Notice of Survey, Records, Curriculum, Privacy, and Related Rights and Opt-Out Forms booklets. PDF icon한국어 (Korean)
Korean 2023-24 One-Page Privacy Opt-Out Flyer Korean version of the 2023-24 One-Page Privacy Opt-Out Flyer. PDF icon한국어 (Korean)
MCH 213: School Entrance Physical Examination Health Information Form/Comprehensive Physical Examination Report/Certification of Immunization PDF iconEnglish (English)
Office of Food and Nutrition Services Civil Rights Complaint Procedure and Form PDF iconOffice of Food and Nutrition Services Civil Rights Complaint Procedure and Form
Retiree Tax Forms PDF iconIRS W-4P Federal Tax Withholding Form PDF iconVA-4P State Tax Withholding Form
S 011: Fraud, Waste & Abuse Reporting Used to report fraud, waste, or abuse to the Office of the Auditor General. PDF iconEnglish (English)
S 020: Student Concussion Evaluation Used to facilitate communication between medical professionals and school staff regarding academic supports for students recovering from a concussion. PDF iconEnglish (English)
S 023: Thomas Jefferson High School for Science and Technology (TJHSST) Transcript Request Form for Current Students Used by TJHSST to request student transcripts. PDF iconEnglish (English)
SB 102: School Board Audit Committee Membership Application This form is used by those in the Fairfax community interested in applying to serve on the School Board Audit Committee. PDF iconEnglish (English)
SE 55: FCPS Advisory Committee for Students with Disabilities (ACSD) Public Interest Form Used by community members, parents, and staff to indicate interest in membership on the ACSD. PDF iconEnglish (English)
Spanish 2023-24 One-Page Privacy Opt-Out Flyer Spanish version of the 2023-24 One-Page Privacy Opt-Out Flyer. PDF iconespañol (Spanish)
SS/SE 10: Special Education Eligibility Form Used by special education staff to conduct a special education services eligibility for a student. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 107: Parent Notice of Eligibility Determination Used by special education staff to notify parents if a student is eligible for special education services. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10A: Autism Basis for Committee Decision Used by special education staff to show basis for decision - autism. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10B: Emotional Disability Basis for Committee Decision Used by special education staff to show basis for decision - emotional disability. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10C: Hearing Impairment Basis for Committee Decision Used by special education staff to show basis for decision - hearing impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10D: Intellectual Disability Basis for Committee Decision Used by special education staff to show basis for decision - intellectual disabilities. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10E: Multiple Disabilities Basis for Committee Decision Used by special education staff to show basis for decision - multiple disabilities. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10F: Orthopedic Impairment Basis for Committee Decision Used by special education staff to show basis for decision - orthopedic impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10G: Other Health Impairment Basis for Committee Decision Used by special education staff to show basis for decision - other health impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10I: Specific Learning Disability Basis for Committee Decision Used by special education staff to show basis for decision - specific learning disability. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10J: Speech/Language Impairment Basis for Committee Decision Used by special education staff to show basis for decision - speech and language impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF iconespañol (Spanish) PDF icon한국어 (Korean) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10K: Traumatic Brain Injury Basis for Committee Decision Used by special education staff to show basis for decision - traumatic brain injury. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10L: Visual Impairment Basis for Committee Decision Used by special education staff to show basis for decision - visual impairment. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10M: Developmental Delay Basis for Committee Decision Used by special education staff to show basis for decision - developmental delay. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10N: Deafness Basis for Committee Decision Used by special education staff to show basis for decision - deafness. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 10P: Deaf-Blindness Basis for Committee Decision Used by special education staff to show basis for decision - deaf/blindness. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 119: Request For Pass-Fail Status Used by FCPS students to request to take a class as pass/fail. PDF iconEnglish (English)
SS/SE 126: Notice of Reevaluation Used by special education staff to conduct a reevaluation of a student. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 127: Parent Information Used by parents to share information with their student's school. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 128: Unilateral Withdrawal from FCPS Used by special education staff to confirm unilateral withdrawal of student from FCPS. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 13: Notice Not to Evaluate Used by special education staff to notify parents their student will not be evaluated for services. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 14: Local Screening Committee Report Used by the local screening committee to report on a student receiving services. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 141: Prior Written Notice Used by special education staff to provide prior notice to parents of FCPS refusal for the placement of their child. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu)
SS/SE 142: Notice of Eligibility Meeting Used by special education staff to provide notice to the parents of an eligibility meeting. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 180: Specific Health Care Procedures Authorization Used by school staff to obtain permission for specific medical procedures for a student. PDF iconEnglish (English)
SS/SE 180A: Specific Health Care Procedures Authorization for G-Tube Feeding Used by parents to obtain healthcare provider authorization of specific orders for students requiring G-tube feedings during school. PDF iconEnglish (English)
SS/SE 2: Notice and Consent for Evaluation Used by special education staff to give notice to as well as get consent from parents to conduct a special education evaluation. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 200: Physician’s Referral for Participation in Physical Education Used to obtain a physician's request to modify a student's participation in PE. PDF iconse200
SS/SE 215: Request for Wavier of Full-Day Schedule Requirement Used to obtain permission by FCPS for a student to attend less than a full day. PDF iconEnglish (English)
SS/SE 217: Functional Behavior Assessment (Draft) Draft version of the form used by school staff to conduct a functional behavioral assessment. PDF iconEnglish (English)
SS/SE 218: Behavior Intervention Plan (Draft) Draft version of the form used by school staff to create a functional behavioral plan. PDF iconEnglish (English)
SS/SE 218A: Behavior Intervention Plan Review (Draft) Draft version of the form used by school staff to review a functional behavioral plan. PDF iconEnglish (English)
SS/SE 219: Criminal Conviction and Juvenile Delinquency Adjudication Affirmation Used by parents to affirm their student has not been adjudicated for a crime. PDF iconse219
SS/SE 228: Pre-Kindergarten Experience Used by parents to indicate their student's pre-k experience. Used for statistical purposes only. PDF iconse228
SS/SE 251: Eligibility Committee Additional Data Required Used by special education staff to obtain additional data for eligibility meetings. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 264: Emergency Use of Physical Restraint & Seclusion (Incident Documentation) Used by school staff to document emergency use of physical restraint. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
SS/SE 266: Parent Consent for Individualized Screening and Consultation Used to obtain parental consent for individual screening and consultation. PDF iconEnglish (English) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu)