Based upon direction from the Minnesota Legislature, the Minnesota Department of Education (MDE), Division of Compliance and Assistance, convened a work group to review our current special education forms to determine whether revisions were necessary to accommodate individual form users, especially those who may have a reading disability. The work group included reading specialists from the Division of Special Education, Academic Standards and Instructional Effectiveness, and a reading specialist from the University of Minnesota. Based upon multiple opportunities for parental feedback, the Compliance and Assistance Division revised the due process forms for prior written notice, consent and objection and special education evaluations. These revised documents include templates, guidance documents and sample documents designed to assist districts in drafting due process forms and evaluation reports that are more easily understand by individuals who may have a reading disability.

By providing due process forms that follow federal and state laws and regulations, the Compliance and Assistance Division assists school districts meet the requirements. These forms include information on parents' and students' rights and due process options, communicate with parents, track a student’s progress, and create and maintain Individualized Education Programs (IEP). MDE forms are available for school districts to use; however, school districts may develop their own forms. Forms that have translated versions are listed below.

Please note: Several forms are in Word 2010 format. If you have an older version of Word, save forms to your computer and then open from that location.

• Evaluation Report Model Form - 10/11/18
  This model form provides a means of formatting and completing an evaluation report that is easier for parents to understand.
• Consent/Objection Model Form - 10/11/18
  Allows parents to consent or object to district proposals.
• Evaluation Report Model Form Guidance - 10/10/18
  This guidance document is designed to accompany the Evaluation Report Model Form. Content includes required components of a compliant evaluation report as well as legal references.
• Prior Written Notice Example Document - 10/10/18
  Attached is an example of how a prior written notice can me completed in an understandable format for parents. This is an exemplar to provide guidance to special education completing prior written notices.
• Prior Written Notice Model Form Guidance - 10/10/18
  Provides district guidance for completing prior written notices.
• Prior Written Notice Model Form - 10/9/18
  Model form recommended for district use to notify parents when the district proposes or refuses special education services.
• Evaluation Report Example Document - 10/9/18
  Attached is an example of how a reevaluation can be written in an more understandable format for parents. This is an exemplar to provide guidance to special education staff writing evaluations/reevaluations.
• Prior Written Notice - Part C - 6/6/17
  Model form provided to parents prior to beginning or refusing to begin early intervention evaluations, assessments and services.
• Private School Refusal to Sign Written Affirmation - 11/25/14  PDF 
  Model form for public schools when a private school has refused to sign a written affirmation after a consultation during the design and development of special education and related services for a parentally placed private school child with disabilities.
• Individualized Education Program (IEP) Rubric - 5/30/14
  MDE’s rubric listing the IEP elements required by both the IDEA and Minnesota law.
• Individualized Education Program (IEP) Form - 5/27/14
  The U.S. Department of Education’s model IEP form containing the federal requirements of the IDEA only.
• Manifestation Determination Form - 2/12/13
  Optional form for an IEP team to determine if a special education student's behavior is or is not a manifestation of his or her disability.
• Manifestation Determination Form Guidance - 2/7/13
  Technical assistance to individuals completing the Manifestation Determination form.
• Individual Family Service Plan (IFSP) Form Guidance - 5/10/12
  Technical assistance to individuals completing the IFSP form.
• Individual Family Service Plan (IFSP) Form - 5/9/12
  Outline for creating an IFSP for an infant or toddler with disabilities under age three.
• Prior Written Notice - Part C Guidance - 5/3/12
  Technical assistance to individuals completing the Prior Written Notice - Part C form.
• Private School Complaint Form - 3/5/12
  For use by private schools regarding public school district consideration to views of private school design and development of special education and related activities for children with disabilities.
• Private School Consultation Form - 3/1/12
  For use by public schools to affirm compliance with the Individuals with Disabilities Education Act (IDEA) requirement that districts "obtain written affirmation signed by representatives of participating private schools" that timely and meaningful consultation has occurred.