List of FCPS Forms to Search

Used by staff to request a calculator accommodation for a student.

Used by special education staff to list Read Aloud or Audio Accommodation criteria.

Used by FCPS staff to notify parents of an upcoming 504 meeting.
This notice is sent to parents prior to their child’s 504 Initial Qualification, 504 Plan, or 504 Reevaluation meeting.

Used by schools to gather emergency contact information for a student.

Used to supply a residence affidavit in order for a parent to enroll their student.

Used to supply a residence attestation in order for a parent or guardian to enroll their student.

Used by a parent or student to request a transfer to another FCPS school due to a health issue.

Used to identify students who are military connected.

Used by a student to request time away for lactation purposes.

Used by FCPS students to request a transfer into the Global STEM Challenges program.

Used by parents to request their student be placed in the Early Literacy program.

Used by parents to request their student be placed in the Hippy program.

Used by FCPS students to certify their inability to make educational decision under IDEA.

Used to obtain a specific power of attorney to make educational decisions under IDEA.

Used by parents to enroll their family in the ESOL Family Literacy program.

Used by special education staff to request special permission for a locally awarded verified credit.

Used by parents to request principal approval of their student wearing a GPS device.

Used by IEP staff to determine credit accommodations eligibility.

SS/SE 365: Student Quarantine Exemption and Attestation Form

Used to identify IEP or 504 Plan Accommodations at the elementary school level.

Used to identify IEP or 504 plan accommodations at the middle school level.

Used to identify IEP or 504 plan accommodations at the high school level.

Used by parents, guardians, emancipated students, or students who are the Age of Majority to invite and authorize a partner agency to attend and participate in a students' FCPS IEP meeting.

Used by schools when a student is being considered for instruction outside of the general education setting regardless of the duration.

Provides procedures and requirements for students to be in possession of Naloxone on school grounds.

This form will be used to explain the Applied Studies Diploma and list programs and supports that students can pursue.

Used to inform parents of their student's special education rights.

Used by FCPS employees when students return to school after an extended absence.

World Language credit accommodation for students who have an Individualized Education Program and are pursuing the Advanced Studies Diploma.

Used by schools to refer a student for evaluation.

Used to refer a student for a surrogate parent.

Used by schools to refer a student for evaluation, page 2.

Used by schools to report on a student's reevaluation.

Used to give school the authorization to dispense medication to a student.
Please submit the English version of this form to your school for processing.
Por favor, envíe la versión en inglés de este formulario a su escuela para su procesamiento.

Parent/health care provider authorization for the administration of epinephrine to a student with anaphylaxis.
Please submit the English version of this form to your school for processing.
Por favor, envíe la versión en inglés de este formulario a su escuela para su procesamiento.

Used to authorize school employees to follow a student's Virginia Asthma Action Plan.
Please submit the English version of this form to your school for processing.

Used to collect health information yearly on a student.
Please submit the English version of this form to your school for processing.
Por favor, envíe la versión en inglés de este formulario a su escuela para su procesamiento.

Used by FCPS schools to request student records from another school division.

Used by parents to give FCPS schools authorization to release their student's record.

Used by parents to give FCPS schools authorization to share confidential information.

Used by FCPS schools to determine primary language spoken at a student's home.

Used by special education staff to notify parents of a screening committee meeting.

Used by special education staff to determine whether to do a 504 plan.

Used to identify that an FCPS student has qualified for an accommodation under Section 504.

The 504 Plan form is completed by the knowledgeable committee during a student’s 504 plan meeting. Accommodations, modifications, and/or services necessary to afford the student the equal opportunity to access school programs and activities are addressed with the 504 plan document.

Used to identify the 504 accommodation delivered at the elementary level.

Used to identify the 504 accommodation delivered at the middle school level.

Used to identify the 504 accommodation delivered at the high school level.

Used by 504 staff to provide prior written notice to parents.

Used to document services needed for an FCPS student under a 504 accommodation.

Used to communicate Section 504 Procedural Safeguards for parents.
Parents are provided a copy of the 504 procedural safeguards notice prior to evaluation, Child Find, identification, reevaluation, and/or placement.