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Assessment/Evaluation
Medical Statement fillable form
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 PDFScreening Forms
Screening Permission Form (English)
Screening Permission (Spanish)
Screening Permission (Vietnamese)
Screening Permission (Russian)
Screening Permission (Chinese)
Screening Results Form (English)
Screening Results (Vietnamese)
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.
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)
Guidance DocumentsKTEA 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 thestudent’s progress during instruction in reading and/or math. Progress monitoring documents how a student responds toappropriate 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.