Fillable Section 504 Meeting Parent Input Who has legal (Bureau of Indian Affairs)

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Section 504 Meeting Parent Input Who has legal (Bureau of Indian Affairs)

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Section 504 Meeting
Parent Input
Student Name: Date:
School: Grade:
Parent’s / Guardian’s Name: _____
Parent’s / Guardian’s Name: __________
Who has legal authority to make educational decisions for this child?
With whom does this student live?
Please answer any questions that you think might be helpful to the 504 Team.
(Please attach additional paper if needed or documents that you feel might be helpful)
What are some of your child’s strengths?
_____
What does your child do when not in school?
__________
Please describe your child’s behavior at home
What activities does the family do together?
Have any family members had learning problems?
Have there been any important changes within the family during the last 3 years?
Do you feel your child is experiencing problems in school?
When were you first aware of this problem?
What do you think is causing the problem?
What time does your child go to bed at night?
Does your child usually eat breakfast?
What methods of discipline are used with your child at home?
What is your child’s reaction to discipline?
Has your child mentioned any problems with school? If so, how does he/she feel about
the problem?
Health History
Were there any problems before, during, or immediately after birth?
Please describe any serious illnesses, accidents, or hospitalizations.
Does your child appear to have any physical health problems, including allergies?
Is your child receiving service(s) from another agency?
Is your child currently taking medications? If so, please list.
Are there any known side effects from the medication?
______________________________________________________________
Please tell us anything else that you think would be helpful in planning for your
child’s success at school.
(This document is not a requirement but will be helpful in determining how to best serve your child)
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Section 504 Meeting Parent Input Who has legal (Bureau of Indian Affairs)

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Completed 26 January 2021

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