Electronic Forms Image

    Click on the drop down box for a hyperlinked list of forms

    relevant to each content area.




Algebra 1 Waiver Application

Alternate Curriculum New Special Day Program (SDP) Materials Verification Form

Classroom Observation Checklist

School Based Enterprise Business Proposal - Fillable

School Based Enterprise Financial Report - Fillable

School Based Enterprise Reflection - Fillable

Verification of Required Administrative Support to Alternate Curriculum SDP Substitute Teacher

Additional Time/Overtime for Transportation Requests for Use By Special Education Schools and Centers

Additional Time/Overtime Request Form

ATLL Equipment Evaluation

ATLL Equipment Loan

ATLL Library Training Request

ATLL Pre-Visit Questionnaire

Site Authorization for Short-Term Equipment Loan

Multi-tiered Implementation Assessment

ICEL by RIOT Definitions

ICEL by RIOT Matrix Worksheet

The Interim Behavior Response Plan

Functional Behavior Assessment Report

Behavior Emergency Report for Students with Disabilities

Non-Suicidal Self-Injurious Behavior Referral

CBI Training Verification

Daily Community Travel Plan

Directions to File for Due Process

Annual Early Childhood Special Education Health and Safety Review - Universal PrecautionsAnnual Early Childhood Special

Education Health and Safety Review -Toileting Procedure Skills Performance Checklist

After School Programs Classified Application 2019-2020

After School Programs Certificated Application 2019-2020



ESY Eligibility Worksheet - Fillable (Uploaded 10.29.18)

Assignment of Educational Decision Making Rights

Written Request for Specific Educational Placement

Review for Support Services Due to Health Needs

IEP Parent Participation Letter

IEP Staff Input Survey

IEP Team Member Written Excusal Form

IEP Instructions for Printing Translated IEPs

School Log of Translated IEP/504 Documents Provided to Parents

COA Referral Form

LAS Service Completion Monitoring and Support - English

LAS Service Completion Monitoring and Support - Spanish

Language and Speech Services (LAS) Certification

Speech Language Impairment Eligibility (SLI) Certification

Learning Center Observation Tool

Checklist (Attachment A)


Records Review (Attachment B)


Worksheet (Attachment C)

Equipment Loan Service Form

Incoming LI Equipment

Outgoing LI Equipment

Procedures for Ordering Equipment for Students who Are Deaf or Hard of Hearing

Procedures for Ordering Equipment for Students with Visual Impairment

Procedures for Ordering Equipment for Students with Orthopedic Impairment

Request for LI Expenditure Form

Request for LI Equipment or Materials

Responsibility Contract - LI Funds

Daily Mileage Statement

M.O.V.E. Parent Consent - English

M.O.V.E. Parent Consent - Spanish

M.O.V.E. - Physician Authorization

Checklist for Considering NPS

NPS Certification

NPS Placement Agreement - Spanish

NPS Placement Agreement

Recommendation for NPS Placement - SE25

Parent Request for Reasonable Accommodation - English


Parent Request for Reasonable Accommodation - Spanish

Prior Written Notice Regarding Parent Request to Revoke Consent for the Continued Provision of SPED and Related Services

Release of Info Form Private Schools

Individual Services Plan - Private Schools

Public Choice Form

Division of Special Education ADA Program Accessibility Request Form

Request for Records - English (Fillable)

Request for Records - Spanish (Fillable)

Request for A Surrogate Parent

Program Support Coverage Log

School Self-Review Checklist, Students with Disabilities 2019-2020 (REF-2624.15)

Standards for Teaching Students Who Are Deaf or Hard of Hearing Listening and Speaking Programs

Summary of Performance - Alt. Curric

Summary of Performance - Gen. Curric

OneAccess Request System for Welligent for charter schools and non-LAUSD personnel (uploaded 2.5.18)

Request for Welligent User ID for LAUSD Employees (Uploaded 2.5.18)

Welligent Login Guide (Uploaded 2.5.18)