Services / ESY Services
Last Name First Name Meeting Date

 
Teacher* Teacher*
  If the teacher is not listed in the pop-up, try entering the name or code here:
You can also select by teacher assignment.
 
Provider type (*infants/mental health svcs.) Provider type (*infants/mental health svcs.)
 
Individual/Group Individual/Group
 
School* School*
 
  If the school is not listed in the pop-up, try entering the school name or code here:
 
Location type* Location type*
 
Service* Service*
 
Primary service Primary service
 
Extended school year Extended school year
 
Consult Consult
 
Start date* Start date*
 
End (evaluation) date End (evaluation) date
 
Frequency code (*infants/mental health svcs.) Frequency code (*infants/mental health svcs.)
 
Duration, minutes per session (*infants/mental health svcs.) Duration, minutes per session (*infants/mental health svcs.)
 
Duration (other description) Duration (other description)
 
Sessions per week Sessions per week
 
Frequency (other) Frequency (other)
 
LEA district LEA district
 
Drop date Drop date
 
Primary drop reason Primary drop reason
 
Non-primary drop code-reason Non-primary drop code-reason (non-primary service only)
 
For information only:
Drop date
Primary drop reason - Non-primary drop reason -

*Required items