ESE / Student Services
Attendance Forms
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Educational Planning Team Recommendation--Attendance Intervention - STU-2324-008
STU-2324-008 - Educational Planning Team Recommendation Form--Attendance Intervention.pdf 178.73 KB (Last Modified on November 15, 2023) -
Notice for Child to Attend School - STU-2223-011
This is the Spanish version of the Skyward "Notice for Child to Attend School" form.
STU-2223-011 - Notice for Child to Attend School in Espanol.pdf 93.73 KB (Last Modified on January 9, 2023) -
Parent-Guardian Contact Log - by Attendance Officer - STU-2223-004 (Word).pdf
STU-2223-004 - Parent-Guardian Contact Log - by Attendance Officer-WORD.docx 25.69 KB (Last Modified on September 8, 2022) -
Parent-Guardian Contact Log - By School - STU-2223-005 (Word)
STU-2223-005 - Parent-Guardian Contact Log - By School-WORD.docx 24.27 KB (Last Modified on September 8, 2022) -
Truancy Affidavit for Parental Prosecution (Elem)-STU-2324-012
STU-2324-012 - Truancy Affidavit for Parental Prosecution - Elementary.pdf 273.44 KB (Last Modified on February 16, 2024) -
Truancy Intervention Documentation (Middle-High)--STU-2324-013
STU-2324-013 - Truancy Intervention Documentation - Middle-High.pdf 119.23 KB (Last Modified on March 20, 2024)
Bright Futures Forms
Discipline Forms
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Alternative Learning Center Parent Form w/Procedures - STU-2324-010
STU-2324-010 - Alternative Learning Center Parent Form w-Procedures.pdf 225.93 KB (Last Modified on January 29, 2024) -
Alternative Learning Center School Referral Form - STU-2324-009
STU-2324-009 - Alternative Learning Center School Referral Form.pdf 150.44 KB (Last Modified on January 29, 2024) -
Bullying Complaint Report Form - STU-2425-009
Translation: Spanish
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Character Counts Center - Admission Checklist--STU-2223-002.pdf
STU-2223-002 - Character Counts Admission Checklist.pdf 241.16 KB (Last Modified on October 2, 2023) -
Law Enforcement Notification of Student Arrest - STU-2324-015
STU-2324-015 - Law Enforcement Notification of Student Arrest.pdf 105.08 KB (Last Modified on February 19, 2024) -
Suspension Reduction Alternative/Application Form - STU-2425-007
STU-2425-007 - Suspension Reduction Alternative-Application Form.pdf 193.04 KB (Last Modified on October 31, 2024)
Driving Privilege-Related Forms & Links
ESE Eligibility
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Documentation of Staffing/Notice of Eligibility--ESE-2425-005
ESE-2425-005 - Documentation of Staffing - Notice of Eligibility.pdf 271.22 KB (Last Modified on November 4, 2024) -
Information for Parents on Funding Levels at Initial ESE Placement, ESE-2324-021
ESE-2324-021 - Information for Parents on Funding Levels at Initial ESE Placement.pdf 179.39 KB (Last Modified on February 28, 2024) -
Informed Notice and Consent for Initial Placement - ESE-2324-022
ESE-2324-022 - Informed Notice and Consent for Initial Placement.pdf 339.9 KB (Last Modified on February 28, 2024) -
Informed Notice and Consent for Initial Placement - Pre-Kindergarten - ESE-2425-008
ESE-2425-008 - Informed Notice and Consent for Initial Placement - Pre-K.pdf 341.35 KB (Last Modified on November 4, 2024) -
Informed Notice of Ineligibility - Pre-K - ESE-2425-009
ESE-2425-009 - Informed Notice of Ineligibility - Pre-K.pdf 316.87 KB (Last Modified on November 4, 2024) -
Informed Notice/Change of Placement or Dismissal - ESE-2425-006
ESE-2425-006 - Informed Notice-Change of Placement or Dismissal.pdf 402.37 KB (Last Modified on November 4, 2024) -
Multidisciplinary Evaluation Team Written Report for SLD and LI - ESE-2425-001
ESE-2425-001 - Multidisciplinary Evaluation Team Written Report for SLD and LI.pdf 491.6 KB (Last Modified on September 24, 2024) -
Multidisciplinary Team Report for Students with Autism Spectrum Disorder - ESE-2425-004
ESE-2425-004 - Multidisciplinary Team Report-Students w Autism Specrum Disorder.pdf 233.52 KB (Last Modified on October 28, 2024) -
Multidisciplinary Team Report-Students with Other Health Impairments - ESE-2425-003
ESE-2425-003 - Multidisciplinary Team Report-Students w Other Health Impairments.pdf 199.53 KB (Last Modified on September 18, 2024) -
Multidisciplinary Team Report/Students w-Intellectual Disabilities - ESE-2425-002
ESE-2425-002 - Multidisciplinary Team Report-Students w Intell Disabilities.pdf 198.54 KB (Last Modified on October 28, 2024)
ESE Evaluation/Re-Evaluation
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Informed Notice and Consent for Re-Evaluation - ESE-2425-010
ESE-2425-010 - Informed Notice and Consent for Re-evaluation.pdf 273.46 KB (Last Modified on November 5, 2024) -
Pragmatic Language Evaluation Report--ESE-2324-025
ESE-2324-025 - Pragmatic Language Evaluation Report.pdf 285.03 KB (Last Modified on February 29, 2024) -
Referral Checklist for Re-Evaluation (Change-Add Program) ESE-2324-026
ESE-2324-026 - Referral Checklist for Re-evaluation - Change Add Program.pdf 318.12 KB (Last Modified on August 28, 2024) -
Referral Checklist for Reevaluation--Current Program Only - ESE-2324-027
ESE-2324-027 - Referral Checklist for Re-Evaluation--Current Program Only.pdf 269.12 KB (Last Modified on February 29, 2024)
ESE Forms - General
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Curriculum-Based Vocational Assessment (CBVA) Rating Form - ESE-2324-030
ESE-2324-030 - Curriculum-Based Vocational Assessment CBVA Rating Form.pdf 164.39 KB (Last Modified on March 4, 2024) -
District Program Referral Packet - ESE-2324-031
ESE-2324-031 - District Program Referral Packet--Not Fillable.pdf 288.64 KB (Last Modified on March 7, 2024) -
Horizon Center Admission Checklist - ESE-2324-045
ESE-2324-045 - Horizon Center Admission Checklist Supplement for ESE Students.pdf 207.47 KB (Last Modified on May 24, 2024) -
Interagency Release of Information-Records - ESE-2425-012
ESE-2425-012 - Interagency Release of Information-Records.pdf 209.83 KB (Last Modified on November 5, 2024) -
Parental Consent for Medicaid Reimbursement - ESE-021-003
ESE-021-003 - Parental Consent for Medicaid Reimbursement.pdf 186.35 KB (Last Modified on October 6, 2020) -
Parental Consent for Medicaid Reimbursement - Espanol - ESE-021-003
ESE-021-003 - Parental Consent for Medicaid Reimbursement-Espanol.pdf 154.56 KB (Last Modified on October 1, 2021) -
Procedures for Collaboration of Public and Private Instructional Personnel - ESE-2425-011
ESE-2425-011 - Procedures for Collaboation of Public and Private Personnel Agreement.pdf 231.57 KB (Last Modified on November 5, 2024) -
Transfer of Rights at Age of Majority (Age 18) Parent Notification - ESE-2324-018
ESE-2324-018 - Transfer of Rights at Age of Majority-18-Parent Notification.pdf 241.38 KB (Last Modified on December 8, 2023) -
Transfer of Rights at Age of Majority (Age 18) Student Notification - ESE-2324-019
ESE-2324-019 - Transfer of Rights at Age of Majority-18-Student Notification.pdf 215.16 KB (Last Modified on December 8, 2023) -
Waiver of State Standardized Assessment--ESE-021-002.pdf
ESE-021-002 - Waiver of State Standardized Assessment.pdf 262.93 KB (Last Modified on April 28, 2020)
ESE Hospital Homebound
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Homebound/Hospital Status of Exit or Withdrawal - ESE-2425-015
ESE-2425-015 - Homebound-Hospital Status of Exit or Withdrawal.pdf 173.41 KB (Last Modified on November 5, 2024) -
Hospital-Homebound Medical Certificate - ESE-2324-039
ESE-2324-039 - Hospital-Homebound Medical Certificate.pdf 304.92 KB (Last Modified on October 1, 2024) -
Physician's Report for Re-entry of Student to School - ESE-2324-040
ESE-2324-040 - Physicians Report for Re-entry of Student to School.pdf 139.29 KB (Last Modified on March 22, 2024) -
Student-Parent Agreement for Hospital Homebound Services - ESE-2324-041
ESE-2324-041 - Student-Parent Agreement for Hospital Homebound Services.pdf 157.2 KB (Last Modified on March 22, 2024)
ESE Transition / CBVE
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Career Placement/On-the-Job Training Agreement - ESE-2425-016
ESE-2425-016 - Career Placement - On the Job Training Agreement.pdf 188.9 KB (Last Modified on November 5, 2024) -
Transition Assessment (Ages 11-13) Form A - ESE-2324-004
ESE-2324-004 - Transition Assessment--Ages 11-13--Form A.pdf 188.73 KB (Last Modified on July 7, 2023) -
Transition Assessment (Ages 11-13) Form B - ESE-2324-005
ESE-2324-005 - Transition Assessment--Ages 11-13--Form B.pdf 174.07 KB (Last Modified on December 5, 2023) -
Transition Assessment (Ages 11-13) Form C - ESE-2324-006
ESE-2324-006 - Transition Assessment--Ages 11-13--Form C.pdf 135.79 KB (Last Modified on October 9, 2023) -
Transition Assessment (Ages 14-16) Form A - ESE-2324-007
ESE-2324-007 - Transition Assessment--Ages 14-16--Form A.pdf 162.94 KB (Last Modified on July 7, 2023) -
Transition Assessment (Ages 14-16) Form B - ESE-2324-008
ESE-2324-008 - Transition Assessment--Ages 14-16--Form B.pdf 137.35 KB (Last Modified on July 7, 2023) -
Transition Assessment (Ages 14-16) Form C - ESE-2324-009
ESE-2324-009 - Transition Assessment--Ages 14-16--Form C.pdf 187.84 KB (Last Modified on July 7, 2023) -
Transition Assessment (Ages 16+) Form A - ESE-2324-010
ESE-2324-010 - Transition Assessment--Ages 16 Plus--Form A.pdf 138.86 KB (Last Modified on December 5, 2023) -
Transition Assessment (Ages 16+) Form B - ESE-2324-011
ESE-2324-011 - Transition Assessment--Ages 16 Plus--Form B.pdf 140.92 KB (Last Modified on December 5, 2023) -
Transition Assessment (Ages 16+) Form C - ESE-2324-012
ESE-2324-012 - Transition Assessment--Ages 16 Plus--Form C.pdf 157.15 KB (Last Modified on July 7, 2023)
Gifted EP
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Gifted Consultation / Support Facilitation--ESE-2324-043
ESE-2324-043 - Gifted Consultation-Support Facilitation.pdf 151.16 KB (Last Modified on March 29, 2024)
Gifted Referral Forms
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Checklist of Gifted Characteristics--ESE-2324-014.pdf
ESE-2324-014 - Checklist of Gifted Characteristics.pdf 175.16 KB (Last Modified on October 10, 2023) -
Gifted Pre-Referral Data Summary Sheet--ESE-2324-013.pdf
ESE-2324-013 - Gifted Pre-Referral Data Summary Sheet.pdf 175.09 KB (Last Modified on October 20, 2023) -
Invitation to Educational Planning Conference - Gifted - ESE-2324-016
ESE-2324-016 - Invitation to Educational Planning Conference - Gifted.pdf 182.82 KB (Last Modified on October 24, 2023) -
Parent Consent for Gifted Program Screening and Pre-Referral - STU-2324-005.pdf
STU-2324-005 - Parent Consent for Gifted Program Screening and Pre-Referral.pdf 149.02 KB (Last Modified on October 20, 2023) -
Screening Checklist of Student Characteristics - ESE-2324-015
ESE-2324-015 - Screening Checklist of Student Characteristics.pdf 271.01 KB (Last Modified on October 11, 2023)
Pre-Referral Forms
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Educational Planning Team Recommendation Form--STU-2324-023
PRINT ONLY & COMPLETE Version - Click Here
STU-2324-023 - Educational Planning Team Recommendaton Form.pdf 231.35 KB (Last Modified on April 3, 2024) -
Hours of Academic Intervention Worksheet--STU-2324-025
STU-2324-025 - Hours of Academic Intervention Worksheet.pdf 137.71 KB (Last Modified on April 3, 2024) -
Monitoring Problem and Replacement Behavior Observation Form-1- STU-2324-026
STU-2324-026 - Monitoring Problem and Replacement Behavior Observation Form--Form 1.pdf 173.6 KB (Last Modified on April 4, 2024) -
Monitoring Problem and Replacement Behavior Observation Form 2 - STU-2324-027
STU-2324-027 - Monitoring Problem and Replacement Behavior Observation Form--Form 2.pdf 158.41 KB (Last Modified on April 4, 2024) -
Pre-K Educational Planning Team Screening Record--STU-2324-028
STU-2324-028 - Pre-K Educational Planning Team Screening Record.pdf 161.78 KB (Last Modified on April 4, 2024) -
Private and Home School Educational Screening Record - ESE-2324-003
ESE-2324-003 - Private and Home School Educational Screening Record.pdf 182.18 KB (Last Modified on March 29, 2023) -
Referral Checklist for Initial Speech Evaluation - ESE-2324-044
ESE-2324-044 - Referral Checklist for Initial Speech Evaluation.pdf 154.12 KB (Last Modified on May 16, 2024) -
Referral Checklist for New Evaluation (Disabilities) - STU-2324-033
STU-2324-033 - Referral Checklist for New Evaluation - Disabilities.pdf 292.77 KB (Last Modified on August 28, 2024)
Section 504 Forms
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Notice and Consent for Initial Section 504 Evaluation - STU-021-001.pdf
STU-021-001 - Notice and Consent for Initial Section 504 Evaluation.pdf 162.07 KB (Last Modified on November 19, 2021) -
Notice to Parent: Rights Afforded by Section 504 of the Rehabilitation Act of 1973-STU-122-006.pdf
STU-122-006 - Page Two Only-Rights Afforded by Section 504 Committee Meeting.pdf 164.07 KB (Last Modified on February 23, 2023) -
Parent Notice of Section 504 Committee Meeting--STU-122-006
STU-122-006 - Parent Notice of Section 504 Committee Meeting.pdf 209.78 KB (Last Modified on March 20, 2024)
Student Records Forms
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Educational Records Disclosure/Request Log - STU-2324-034
STU-2324-034 - Educational Records Disclosure-Request Log.pdf 149.81 KB (Last Modified on May 16, 2024) -
Notarized Affidavit of Birth Information--STU-920-005.pdf
STU-920-005 - Notarized Affidavit of Birth Information.pdf 164.57 KB (Last Modified on July 2, 2019) -
Release of Student Information Between Agencies - STU-021-012.pdf
STU-021-012 - Release of Student Information Between Agencies.pdf 194.37 KB (Last Modified on July 15, 2021) -
Release of Student Education Record Form to ACPS - STU-2324-035
STU-2324-035 - Release of Student Education Record Form to Alachua County.pdf 184.6 KB (Last Modified on May 16, 2024)
Student Services Forms - General
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ACCEL 18 Credit Standard Diploma Option Agreement - STU-2324-036
STU-2324-036 - ACCEL 18 Credit Standard Diploma Option Agreement.pdf 130.33 KB (Last Modified on May 20, 2024) -
Assurance to Parents of Rights for Parental Input at Meetings - STU-2324-037
STU-2324-037 - Assurance to Parents of Rights for Parental Input at Meetings.pdf 144.48 KB (Last Modified on May 20, 2024) -
Behavior Implementation Monitoring Sheet 2024-25 - STU-2425-002
STU-2425-002 - Behavior Implementation Monitoring Sheet 2024-25.pdf 294.6 KB (Last Modified on September 6, 2024) -
Early Warning System Educational Planning Team Recommendation-STU-920-011.pdf
STU-920-011 - Early Warning System Educational Planning Team Recommendation.pdf 285.51 KB (Last Modified on July 10, 2019) -
Industry Certification Substitution Consent Form - STU-920-010.pdf
STU-920-010 - Industry Certification Substitution Consent Form.pdf 149.7 KB (Last Modified on July 10, 2019) -
Mental Health Interventions Referral Form - STU-2324-038
STU-2324-038 - Mental Health Interventions Referral form.pdf 185.91 KB (Last Modified on May 20, 2024) -
Notice of Intent to Withdraw from Traditional School - STU-2324-039
STU-2324-039 - Notice of Intent to Withdraw from Traditional School.pdf 153.68 KB (Last Modified on May 20, 2024) -
Referral for Mental Health Counseling Services Form - STU-2425-003
STU-2425-003 - Referral for Mental Health Counseling Services Form.pdf 302.39 KB (Last Modified on October 31, 2024)
Student Service/ESE Form Links
Suicide Prevention Forms
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Columbia-Suicide Severity Rating Scale (C-SSRS) - STU-2223-001
STU-2223-001 Columbia-Suicide Severity Rating Scale.pdf 370.9 KB (Last Modified on October 31, 2024)
System of Care
TAP (Teenage Parenting)
TAP (Teenage Parenting) Form Links
Title IX
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Formal Complaint of Sexual Misconduct - Title IX - STU-021-009.pdf
STU-021-009 - Formal Complaint of Sexual Misconduct - Title IX.pdf 134.88 KB (Last Modified on November 4, 2020)