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Portland Public Schools

Portland Public Schools

Portland, Oregon Portland, Oregon

501 N. Dixon St•Portland, OR 97227•(503) 916-2000

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    Assessment/Evaluation

    Medical Statement fillable form

    Medical Statement 

    Test Manual/ Test Kit Request

    When requesting a test manual or kit to be checked out fill out this request form and submit it to Cindy Laureano. Test kits cannot be ponied, but must be picked up at the BESC in L2.

    Word Document (Read Only): This form can be filled out by hand and either scanned and attached via email or sent via the PONY.

    Writable PDF

    Screening Forms

    Screening Permission Form (English)

    Screening Permission (Spanish)

    Screening Permission (Somali)

    Screening Permission (Vietnamese)

    Screening Permission (Russian)

    Screening Permission (Chinese)

     

    Screening Results Form (English)

    Screening Results (Spanish)

    Screening Results (Somali)

    Screening Results (Vietnamese)

    Screening Results (Russian)

    Screening Results (Chinese)

    Evaluation Calendar

    60 School Day Calendar (updated 1/9/19) 

    Corrective Action Form 

    The Corrective Action Form (CAF) is used when an initial evaluation goes over 60 school days. If an initial evaluation goes over 60 school days the case manager needs to submit the completed form to the records clerk. You do not need to submit a CAF if you have completed the written agreement to extend the timeline for a Specific Learning Disabilty eligibility evaluation.

    Corrective Action Form (CAF) 

    Written Agreement Table

    Written Agreement Table 

    Kaufman Test of Educaional Achievement, Third Edition (KTEA-3)

     Academic Evaluation Report Templates (Modifiable Word documents):

     Academic Report - SLD  (Word)

      Academic Report - SLD (Google Doc)

     Academic Report - Not SLD  (Word)

     Academic Report - Not SLD (Google Doc)

     Academic Report - No KTEA  (Word)

     Academic Report - No KTEA (Google Doc)

     KTEA-3 Clusters & Subtests
     
     KTEA-3 Q-Global Scoring Instructions - Step-by-Step 
             
     Guidance Documents
     
     KTEA-3 Initial Evaluation Guide
             
     KTEA-3 Re-Evaluation Guide

     KTEA Training document

     KTEA-3 Training Updated 9/2018 

    Progress Monitoring for Specific Learning Disability

     Progress monitoring is the documentation of a student’s achievement on a regular basis.  It involves the formal assessment of the  
     student’s progress during instruction in reading and/or math. Progress monitoring documents how a student responds to          
     appropriate instruction, and it may be collected for a single student or for an entire class.  
     Progress monitoring must include a minimum of four data points. These data are typically collected once every two weeks.
            
     Student Progress Monitoring Worksheet
     
     SLD Guidelines from the Special Education Procedures manual

Portland Public Schools

501 N. Dixon St

Portland, OR 97227

(503) 916-2000

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Portland Public Schools recognizes the diversity and worth of all individuals and groups and their roles in society. It is the policy of the Portland Public Schools Board of Education that there will be no discrimination or harassment of individuals or groups on the grounds of age, color, creed, disability, marital status, national origin, race, religion, sex or sexual orientation in any educational programs, activities or employment.

ADA Accessibility/District 504 Contact: 503-916-5460
ADA Employment Queries Contact: 503-916-3544
Title VI Contact: 503-916-6499
Title IX Contact: 503-916-3340
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