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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)
--- Eligibility Determination (complete at meeting as a committee)

--- 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.