Employees
Page Navigation
- Los Angeles Unified School District
- Forms (Division of Special Education)
-
Click on the drop down box for a hyperlinked list of forms
relevant to each content area. All forms are available in fillable PDF format.
- Adult Education
-
Participation in Adult Secondary Education Program Checklist (BUL-076303)
Participation in Adult Secondary Education Search and Serve Letter (BUL-076303)
- Algebra 1 Waiver Form
- Alternate Curriculum
-
Alternate Curriculum New Special Day Program (SDP) Materials Verification Form (REF-5749.1)
Classroom Observation Checklist
School Based Enterprise Business Proposal - Fillable (REF-6032.2)
School Based Enterprise Financial Report - Fillable (REF-6032.2)
School Based Enterprise Reflection - Fillable (REF-6032.2)
- Assistant Overtime
-
Additional Time/Overtime for Transportation Requests for Use By Special Education Schools and Centers (BUL-5616.2)
Additional Time/Overtime Request Form (BUL-5616.2)
- Assistive Technology Lending Library (ATLL)
-
ATLL Equipment Evaluation (BUL-5540.0)
ATLL Equipment Loan (BUL-5540.0)
ATLL Library Training Request (BUL-5540.0)
ATLL Pre-Visit Questionnaire (BUL-5540.0)
Site Authorization for Short-Term Equipment Loan (BUL-5540.0)
- Behavior
-
Multi-tiered Implementation Assessment (BUL-6269.1)
ICEL by RIOT Definitions (BUL-6269.1)
ICEL by RIOT Matrix Worksheet (BUL-6269.1)
The Interim Behavior Response Plan (IBRP) (BUL-6269.1)
Functional Behavior Assessment (FBA) Report Template (BUL-6269.1)
Functional Behavior Assessment (FBA) Report Rubric (BUL-6269.1)
Behavior Emergency Report for Students with Disabilities (BUL-6269.1)
Non-Suicidal Self-Injurious Behavior (NSSIB) Referral (BUL-6269.1)
- Community Based Instruction
-
CBI Training Verification (BUL-4438.0)
- Due Process
-
Directions to File for Due Process (REF-1410.9)
- Early Childhood Special Education
-
Annual Early Childhood Special Education Health and Safety Review - Universal Precautions (REF-6777.1)
Education Health and Safety Review -Toileting Procedure Skills Performance Checklist (REF-6777.1)
___________________________________________________________________
After School Programs Classified Application 2019-2020 (MEM-071901.0)
After School Programs Certificated Application 2019-2020 (MEM-071901.0)
- Extended School Year (ESY)
- Foster Care Placement
-
Assignment of Educational Decision Making Rights (REF-6033.0)
Written Request for Specific Educational Placement (REF-6033.0)
- Health Needs
-
Review for Support Services Due to Health Needs (REF-2481.4)
- IEP Parent Participation Letter
-
IEP Parent Participation Letter for Students Suspected of Emotinal Disturbance (BUL-4182.1)
Letters in additional languages available in Welligent Downloads.
- IEP Staff Input Survey
- IEP Team Member Excusal Form
-
IEP Team Member Written Excusal Form - Eglish (REF-3804.0)
IEP Team Member Written Excusal Form - Spanish (REF-3804.0)
Excusal Forms in additional languages available in Welligent Downlaods
- IEP Translation Request Form
-
IEP Instructions for Printing Translated IEPs (REF-6439.2)
School Log of Translated IEP/504 Documents Provided to Parents
- Independent Study
- Language and Speech
-
LAS Service Completion Monitoring and Support - English (REF-4568.1)
LAS Service Completion Monitoring and Support - Spanish (REF-4568.1)
Language and Speech Services (LAS) Certification (BUL-4191.2)
Speech Language Impairment Eligibility (SLI) Certification (BUL-4191.2)
- Learning Center Observation
- Long Term English Learner (LTEL) Reclassification - (Updated 9.18.19)
-
LTEL Reclassification Checklist, Records Review, Worksheet to Determine Reclassification (BUL-6890.2)
- Low Incidence Equipment
-
Procedures for Ordering Equipment for Students with Visual Impairment (BUL-3666.4)
Procedures for Ordering Equipment for Students who Are Deaf or Hard of Hearing (BUL-3666.4)
Procedures for Ordering Equipment for Students with Orthopedic Impairment (BUL-3666.4)
Request for LI Expenditure Form (BUL-3666.4)
- Mileage
- MOVE (Mobility Opportunities Via Education)
-
M.O.V.E. Parent Consent - English (BUL-2087.1)
M.O.V.E. Parent Consent - Spanish (BUL-2087.1)
M.O.V.E. - Physician Authorization (BUL-2087.1)
- Nonpublic Schools (NPS)
-
Checklist for Considering NPS (BUL-5757.3)
NPS Certification (BUL-5757.3)
Recommendation for NPS Placement - SE25 (BUL-5757.3)
Parent's Guide to Exploring NPS Placement Options - English (BUL-5757.3)
Parent's Guide to Exploring NPS Placement Options - Spanish (BUL-5757.3)
NPS Placement Agreement - English (BUL-5757.3)
NPS Placement Agreement - Spanish (BUL-5757.3)
- Parent Request for Reasonable Accommodation
- Parent Revocation of Special Education
-
Additional Languages available in Welligent Downloads.
- Private Schools
-
Release of Infomation Form Private Schools (REF-6846.0)
Individual Services Plan - Private Schools (REF-6846.0)
Request to Add a Non-LAUSD Student Record to Welligent (REF-6846.0)
- Psycho-Educational Reassessment Determination for Three-Year Reviews
-
Three-Year Psycho-Educational Reassessment Determination Worksheet - (BUL-6639.0)
- Rapid Access Program
-
Division of Special Education ADA Program Accessibility Request Form (Link to Google Doc)
- Records Requests
- Request for a Surrogate Parent
- Request for Assessment
-
Request for Special Education Assessment - English
Request for Special Education Assessment - Spanish
Forms in additional languages available in Welligent Downloads.
- School Matrix Program Supports
- School Self Review Checklist
-
School Self-Review Checklist, Students with Disabilities 2020-21 (REF-2624.16)
- Special Education Evaluations
-
Review and Consideration for Request for Special Education Evaluation Sample Letter - English (BUL-4140.2)
Review and Consideration for Request for Special Education Evaluation Sample Letter - Spanish (BUL-4140.2)
_________________________________________________________________________________________
Agreement to Waive Initial Evaluation - English (BUL-4140.2)
Agreement to Waive Initial Evaluation - Spanish (BUL-4140.2)
- Standards for Teaching Students Who Are Deaf and/or Hard of Hearing
- Summary of Performance (Transition)
-
Directions for Completing Summary of Performance (BUL-5796.2)
- Welligent
-
Request for Welligent User ID for LAUSD Employees (Form updated 7.19.19)
OneAccess Request System for Welligent for Charter Schools and Non-LAUSD Personnel