Fillable Essex County Services for Children with Disabilities DAILY (Monroe-Woodbury Central School District)

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Essex County Services for Children with Disabilities DAILY (Monroe-Woodbury Central School District)

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Essex County Services for Children with Disabilities
DAILY SESSION NOTES
PRESCHOOL
Child’s Name__________________________ __________________________
Last First
Type Of Service_______________________ Month:_______________ Year:___________________
Frequency:____________________________ IEP Dates:____________ Thru___________________
School District:________________________ Total sessions this month________________________
Signature of Parent or Guardian:___________________________________________
Signature verifies review of goals and progress
Short Term Goals Progress
DATE
MAKE
UP
FOR TIME IN
TIME
OUT
TOTAL
TIME LOCATION CAREGIVER SIGNATURE
__________________________________________ _____________________________________
Teacher/Therapist Signature/Credentials Date
_
_________________________________________________
License Number
Do not alter Essex County Forms they have been designed to meet State and Federal requirements.
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Essex County Services for Children with Disabilities DAILY (Monroe-Woodbury Central School District)

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Completed 15 April 2021

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