1. Yes     No
      1. TEAM SIGNATURES


REEVALUATION
Multidisciplinary Team Planning Report
 

I.  Name:  ______________________________________     Date: ________________
 
School: _____________________________ Sp. Ed. Teacher: __________________
 
The reevaluation team is responsible for determining the areas to be assessed based upon a review of the existing data including evaluations, information provided by the parent(s), current classroom based assessments, and observations.
 
II.  Primary Exceptionality:       Secondary Exceptionality: 
 
Current Related Services Provided:     OT PT APE ____________
 
III.  Additional Evaluation Data are Needed to Determine the Following:



Yes     No
      Whether the student continues to be eligible as a student with a disability
 
    The student’s present levels of performance and educational needs

 
Whether the student continues to need special education & related services

 
  Whether additions/modifications to services are needed to enable the
student to meet the IEP annual goals or to participate, as appropriate, in
the general curriculum
 

IV. Reevaluation Recommendations: ___________________________________________

________________________________________________________________________
________________________________________________________________________
 

  Parent Questionnaire

  Special Education Teacher Report/Questionnaire

  General Education Teacher Report/Questionnaire

  Student Questionnaire

  Review of Previous Records

  Health Report

  Intelligence Testing

  Achievement Testing

  Speech / Language Evaluation

  OT / PT Evaluation

  Behavior Rating Scale / Personality Inventory

  Adaptive Behavior Scale

 
Other Individual Assessments: ____________________________



TEAM SIGNATURES

________________________________ ________________________________
________________________________ ________________________________
________________________________ ________________________________
________________________________ ________________________________
________________________________ ________________________________

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