RE-EVALUATION NOT NEEDED
    AGREEMENT FORM
    USD # _______
     

       
    Date: __________________________________________
     
    Student: ________________________________________
     
    Date of last evaluation/re-evaluation: _________________
     
    Name of parent(s)/decision maker: ___________________________________________
     
    Name of school representative: ______________________________________________
     
    Position of school representative: ____________________________________________
     
     
     
    Special education laws require a re-evaluation of a child with an exceptionality at least once every three years, unless the school and the parent(s), or other legally authorized education decision maker, of the student agree that a re-evaluation is unnecessary.
     
    The above named parent(s)/decision maker and school representative agree that a re-evaluation for the above named student is not necessary at this time, and therefore no re-evaluation will be conducted. Both parties understand that a re-evaluation may be requested by either party at any time in the future.
     
     
     
     
     
    _____________________________________________________ ____________
    Parent/Legal Decision Maker/Student if age 18 or more Date
     
     
     
    _____________________________________________________ _____________
    Parent/Legal Decision Maker/Student if age 18 or more Date
     
     
     
    _____________________________________________________ _____________
    School Representative Date
     
    8/22/2005

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