IEP Form 6 – Signature and Parent Consent

1.      IEP Meeting Participants: Have all meeting participants sign and date that they were in attendance. Make sure to include titles of each participant.

 

2.      Consent: Have the parent initial, if they agree in-whole or in-part to the IEP. If they agree only in-part, document the areas they are not in agreement with. Steps to resolve the disagreement should be documented on Form 7.

 

3.      Not Eligible: If team determines child is not eligible for special education, check the appropriate box.

 

4.      No Longer Eligible: If team determines child is no longer eligible for special education, check the appropriate box.

 

5.      Signature: Have parent(s)/guardian/surrogate/adult student sign and date.

 

6.      Public Benefits: If parent agrees to authorize district access to health insurance benefits provided by Medi-Cal, check box and have parent/guardian sign.

 

7.      Students Enrolled in Private Schools by Their Parents: If the student is enrolled in private school by his/her parent, check the box and develop a Services Plan, if appropriate.

 

 

[Source: State SELPA IEP Manual, December, 2007]