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Reason(s) for this proposed action:
Reason(s) for this proposed action:
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Other options considered and reasons why they were rejected:
Other options considered and reasons why they were rejected:
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Interventions and modifications attempted, concerns, and results:
Interventions and modifications attempted, concerns, and results:
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Description of evaluation procedures, test records or report(s) and any other factors (if any) relevant to this proposed action:
Description of evaluation procedures, test records or report(s) and any other factors (if any) relevant to this proposed action:
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Check area(s) of suspected disability (for evaluation only): |
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You have protections under state and federal procedural safeguard provisions. Please refer to the enclosed NOTICE OF
PROCEDURAL SAFEGUARDS for an explanation of these rights. If you would like further information about your rights, the
proposed action, and/or referral, please contact:
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