Services / ESY services entry
Page help

Last Name First Name Meeting Date

1. Items for all students:
 
Teacher/provider name* Teacher/provider name*
(The teacher name does not appear on the printed form, only the teacher code.)

  If the teacher is not listed in the pop-up, try entering the name or code here:
 
School* School*
  If the school is not listed in the pop-up, try entering the school name or code here:
 
Service* Service*
Primary Primary
Report to CASEMIS
Start date* Start date*
End (evaluation) date End (evaluation) date
Location type* Location type*
Provider/responsible agency* Provider/responsible agency*
(appears on the printed form)
Extended school year Extended school year
 

2. For infant (age 0-2) or mental health services:
The following items are required for infant and mental health services. However, they can also be used for non-infant services as well.
 
Provider type Provider type  (*infant/MHS)
Frequency code Frequency code  (*infant/MHS)
Duration, minutes per session Duration, minutes per session  (*infant/MHS)
 

3. Other items:
 
Auxiliary service location Auxiliary service location
Delivery model Delivery model
Consult Consult
LEA district LEA district
 

4. For non-infant, non-MHS services:
 
* Duration (other description) Duration (other description)

Note: This item prints as the duration, provided that the "Duration, minutes per session" (infant section) is zero.

(Describe if other:)   
 
* Frequency (other) Frequency (other)
(Describe if other:)   
 
* Sessions per week Sessions per week

Note: This item prints as the frequency, provided that no "Frequency code" (infant section) and no "Frequency (other)" values are specified.
 

5. For discontinued services:
The following items should be specified when the service has been discontinued:
 
Drop date
Drop reason Drop reason  (primary service only)
Drop code or reason Drop code or reason (non-primary service only)
 

5. For discontinued services:
(for information only, no entry permitted here)
Drop date
Primary drop reason - Non-primary drop reason -

*Required items