Teacher Input Form to IEP
Please take a few minutes to complete this form for your student's upcoming Special Education Meeting.
The information you provide will assist the special education team in developing an appropriate
educational plan for your student. Return this form to: .
Student Name
Case Load Teacher
1) Academic Performance:
(describe classroom habits and study skills)
2)
Behavioral Performance:
(describe behavior in the classroom and list specific examples of
behavior which interfere with academic performance)
3)
Social Interaction:
(describe the students interaction with teachers and other students including
specific incidents where ever possible.
4) Present Classroom Grade: Attach printout (if appropriate)
Number of Tardies:
5) Attendance: Number of Absences:
6) Current classroom accommodations being used and their success:
7) Please describe parents concerns:
(Per conferences and contacts with student's parents)
8) Additional Comments:
Signed:
Date:
Classroom Subject taught:
TeacherInput2IEP.ofm 09/02
