504 Review Process
Student Name: ______________________ Teacher:______________________ Grade:__________________
DOB:______________________ ESIS:_____________ Parent Name/Number:_________________________
Person
Action
Responsible
SAT Team
Annually:
 Determine review date by identifying previous meeting date.
-OR Every third year, complete an Initial 504 Process
SAT Team
Prior to Meeting:
SAT Team
 Send Notice of Invitation to SAT Meeting (SAT Form ITM) to parents, teacher and
SAT Team
 Send Section 504 of the Rehabilitation Act of 1973 Parent Information Guide to
parents
At Meeting:
Review Section 504 Parent Rights Notice with parents
 Complete Section 504 Plan Review (504 Form PR) to determine if the plan should:
o Continue present services with no changes
o Modify the present Section 504 Accommodation Plan (504 Form AP) or create
a new one
o Conduct additional evaluations
o Exit from Section 504 services with rationale.
SAT Team
 Give parents a copy of the 504 Plan Review (504 Form PR) and Section 504
Accommodations Plan, (504 Form AP)
After Meeting:
 Update student information on Synergy using Synergy SE (SAT Form Syn2)
 Get Teacher Receipt of 504 Accommodations Plan (504 Form TR) and Section
504 Review (504 Form TR)
 Give applicable school staff a copy of the 504 Plan Review and Accommodations Plan
(504 Form PR and 504 Form AP)
 Place 504 Cumulative Folder Insert (504 Form CFI) into green folder in student
cumulative file.
 Place all original paperwork in student’s SAT file that is designated by the SAT chair at
each school.
 Put a copy of the Accommodations Plan (504 Form AP) and Section 504 Plan Review
(504 Form PR) in a 504 binder in school vault. In front of 504 binder, please update
Section 504 Chairperson Log (504 Form CL)
 Send copy of Section 504 Plan Review (504 Form PR) and Accommodation Plan (504
Form AP) through inter-office mail to Coordinator of Elementary Instruction, Lydia
Polanco; Instruction Office.
Notice of Invitation to SAT Meeting (SAT Form ITM)
Date of Notice/Invitation:
Dear Parent/Guardian,
In accordance with our Response to Intervention (RTI) Framework, the school has a Student
Assistance Team (SAT) who reviews the educational and/or behavioral needs and progress of any
student who demonstrates a need for supplementary classroom support.
The SAT has been asked to review __________________________’s individual needs to determine if
additional supports are necessary. The team will review existing data and as needed, conduct
observations and/or additional screening.
We need your input and participation in working with us to meet your child’s needs. We invite
you to attend the SAT meeting to contribute your valuable insight. Please sign and return the
bottom of this form to me to indicate if you would like to attend. If you have nay questions or
need to arrange another time to meet, please contact me at the number below.
Meeting date: ________________________
Time: _________________________________
Location: _____________________________
Sincerely,
__________________________________, SAT Chairperson
Telephone Number:_________________________
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Student’s Name:
Home Address:
Telephone number:
Grade:
Teacher:
Parent/Guardian, please check all that apply:
_____ I give my permission for additional screening, if needed.
_____ I DO NOT give my permission for additional screening, if needed.
_____ I plan to attend the SAT meeting.
_____ I do not want to attend the SAT meeting. Please send me a copy of the summary of this
meeting.
_____ I need an interpreter. (Necesito un traductor).
Parent/Guardian Signature:_______________________________________________ Date:_____________________