SAMPLE – EVALUATION FOR SPECIAL EDUCATION/504 ELIGIBILITY REQUEST LETTER

SAMPLE – EVALUATION FOR SPECIAL EDUCATION/504 ELIGIBILITY REQUEST LETTER

_____________________

_____________________

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Parent name & address

_______________ ____, 20__

___________________________

___________________________

___________________________

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Principal or Director of Special Education

Name & address

To Whom It May Concern:

I am requesting a special education evaluation for my child, _____________________________________, pursuant to the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act. Please consider this letter my full consent, as my child’s parent and/or guardian, to evaluate him/her in accordance with the IDEA and Section 504 of the Rehabilitation Act.

My child has the following diagnosis / diagnoses or symptoms ________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________.

As a result of my child’s problems, my child has experienced significant difficulties and I believe that s/he would benefit from a specialized supports in school. My specific concerns are: ________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Check one:

  •  I understand that the school has 45 school days or 90 calendar days to evaluate my child and hold an eligibility meeting.
  • Because my child is currently subject to discipline (suspension, expulsion, or alternative school), I would like this evaluation to be expedited pursuant to 34 CFR Section 300.534(d)(2)(i).

Please contact me at ___________________________ if you have any questions or need additional information. Thank you.

Sincerely,

_____________________

Parent/Guardian