Services

(This form can generate more than one printed page)
Name   IEP Date

 
Service options considered (in selecting LRE, consideration is given to any harmful effect on the child or quality of services that the child needs)
 

 
SPECIAL EDUCATION and RELATED SERVICES
  ESY Services Ind/Grp Provider Start/End Date Frequency Duration Location
Yes No [DNR]  Grp Ind - /wk
NOTE: Pressing CANCEL does not undo changes to the list (above).
 
Special Education Support Exceeds 50% of school day.
 
EXTENDED SCHOOL YEAR (ESY)  
Programs and services will be provided according to when student is in attendance and consistent with the public school calendar and scheduled services, excluding holidays, vacations, and non-instructional days unless otherwise specified.