Fillable Suggested Questions for Parent Input for Re-evaluation Personal (mrjeffreyphillips)

Fill Online, Printable, Fillable, Blank Suggested Questions for Parent Input for Re-evaluation Personal (mrjeffreyphillips) Form

Use Fill to complete blank online MRJEFFREYPHILLIPS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Suggested Questions for Parent Input for Re-evaluation Personal (mrjeffreyphillips)

On average this form takes 14 minutes to complete

The Suggested Questions for Parent Input for Re-evaluation Personal (mrjeffreyphillips) form is 2 pages long and contains:

  • 0 signatures
  • 11 check-boxes
  • 49 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your mrjeffreyphillips forms online.

BROWSE MRJEFFREYPHILLIPS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
A-13, July 2010
Adapted from KRESA
Page 1 of 2
Suggested Questions for Parent Input for Re-evaluation
Student’s Name: ___________________________Parent/Guardian Name: ___________________________
Method of Interview (Check one):
Personal Interview Telephone Written
Person collected input: ____________________________________________ Date: ________________
1. What are some of your child’s strengths, interests and/or favorite activities?
_______________________________________________________________________________________________
_______________________________________________________________________________________________
2. What goals do you have for your child for this school year? For older students, long range goals/plans?
_______________________________________________________________________________________________
3. Have you seen improvement in your child’s academic performance / behavior / speech and language
during the past 3 years?
Yes No Please describe:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
4. Do you have any current concerns about your child’s progress?
_______________________________________________________________________________________________
_______________________________________________________________________________________________
5. Have you seen any recent changes in your child’s behavior or school performance?
Yes No
If yes, please explain:
_______________________________________________________________________________________________
6. Medical information:
Vision concerns? _________________________________________________________________________
o Wears glasses?
Yes No
Hearing concerns? _______________________________________________________________________
o Wears hearing aid(s)?
Yes No
Any other medical/health concerns?
__________________________________________________________________________________________
Medical history: accidents, injuries, surgeries? __________________________________________________
Taking medication (Type, reason, side effects)?
_______________________________________________________________________________________
Any psychological (thinking/emotional) concerns?
_______________________________________________________________________________________
7. Has your child had a psychological or education evaluation from outside of the school in the last 3 years?
Yes No If yes, who did it, when was it done, and what were the results?
_______________________________________________________________________________________________
_______________________________________________________________________________________________
8. Has your child had additional community services in the last 3 years (tutoring, counseling, residential care)?
Yes No If yes, please describe:
_______________________________________________________________________________________________
9. With whom does your child live at home? _____________________________________________________________
A-14, July 2010
Adapted from KRESA
Page 2 of 2
10. Have there been any significant changes in your home or family relationships during the last 3 years?
Yes No If yes, please describe:
_______________________________________________________________________________________________
11. Optional Functional Questions—Younger students
a. Communication skills at home: Understands directions? Communicates needs? Converses?
________________________________________________________________________________
b. Types of chores or responsibilities at home?
________________________________________________________________________________
c. Self care skills: (Bathing, brushing teeth, toileting, etc.)
________________________________________________________________________________
d. Behavior in the community: (Behavior in public places, can get to places nearby, orders meals, etc.)
________________________________________________________________________________
e. Follows safety rules at home and in the community (walking, riding bike).
________________________________________________________________________________
f. Leisure: Shares, has friends
________________________________________________________________________________
Optional Functional Questions – Older students
a. Communication skills at home: Understands directions? Communicates needs? Converses?
________
________________________________________________________________________
b. Types of chores or responsibilities at
home?
________________________________________________________________________________
c. Behavior in the community: Can get to places independently? Shops independently? Knowledge about places
in the community like banks, post offices, gas stations, grocery stores, clothing stores? Other?
________
________________________________________________________________________
d. Follows safety rules and home and in the community (walking, ridi
ng, driving)? Self-care for minor injuries?
________________________________________________________________________________
e. Leisure: Has friends? Participates in school or community activities?
________________________________________________________________________________
12. Do you think your child continues to need special education services?
Yes No
Why? ____________________________________________________________________________________
13. Do you have any suggestions for improving the school services being given to your child?
Yes No
If yes, what are they?
____________________________________________________________________________________
14. Is there any other information about your child that you think may be helpful to your child’s 3-year re-
evaluation?
Yes No If yes, what?
____________________________________________________________________________________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Suggested Questions for Parent Input for Re-evaluation Personal (mrjeffreyphillips)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 19 October 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document