Checklist for Forms
3-Year Re-Evaluation
Meeting Notice
Agreement to Excuse (needed when member/s of IEP team request to be
excused from attending an IEP meeting)
Consent for/Notice of Evaluation
3-Year Re-Evaluation
Services Matrix
If a student is new to the AEA, a service matrix is completed.
Written Prior Notice of Proposed or Refused Action
IEP Page A (Data/Conference)
IEP Page B (Present Level-PLAAFP)
IEP Page C (IEP Results)
IEP Page D or IEP Page E (Goal)
IEP Page F (Special Education Services)
IEP Page G (Special Education Services/LRE)
IEP Additional Information
Extended School Year (ESY)
Justification for Special School Placement
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Form Required
Recommended, if needed
Flow Chart 8882 – Version B – 10/2/06
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Complete only if an increase in
services will change the weighted
enrollment factor
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 if Yes
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