504 plan medical form
[DOC File]Medical Statement Form - USDA Civil Rights (CA Dept of ...
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Citations are from Section 504 of the Rehabilitation Act of 1973, Americans with Disabilities Act (ADA) of 1990, and ADA Amendment Act of 2008: A person with a disability is defined as any person who has a physical or mental impairment which substantially limits one or more major life activities, has a record of such impairment, or is regarded ...
[DOC File]INDIVIDUALIZED EMERGENCY MEDICAL PLAN (IEMP) Section …
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INDIVIDUALIZED EMERGENCY MEDICAL PLAN (IEMP) Section 504 Plan Author: Barbara Ewing-Chow Last modified by: Cyndi Kremer Created Date: 3/19/2012 8:10:00 PM Company: NJC Other titles: INDIVIDUALIZED EMERGENCY MEDICAL PLAN (IEMP) Section 504 Plan
[DOC File]Section 504 Plan for
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This is a Plan developed under Section 504 of the Rehabilitation Act of 1973 (“Section 504”), the Americans with Disabilities Act (“ADA”), and the Individuals with Disabilities Education Act (“IDEA”) to identify the health care-related needs of the student, as well as services and accommodations to be provided to the student.
[DOC File]INDIVIDUAL HEALTH CARE PLAN
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Current Section 504 plan ( No ( Yes (If yes, refer to the Section 504 plan for the Management and Modifications section instead of the Management & Modifications table below.) Management & Modifications Leave this section blank if attaching a Section 504 plan. This column provides example management and modifications in italicized font.
[DOC File]STUDENT EMERGENCY/MEDICAL INFORMATION CARD
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(The Medical Module has fields to enter information from the Student Emergency/Medical Information Card; the Emergency Care Plan, 504 Plan and the Medication Administration Form. Medical Module (8) Field Intent Source of information Medical Form at school Yes = Completed medication form at School Medication Administration Form
[DOC File]Medical Statement for Students with Special Nutritional Needs
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Signature of the School Nutrition Administrator and 504 Coordinator or IEP Case Manager/EC Program representative indicates the medical statement has been received, reviewed, and a plan to address the student’s unique mealtime needs is being developed/implemented. USDA Nondiscrimination Statement
Model Form: Section 504 Checklist
MODEL FORM: SECTION 504 PLAN CHECKLIST. ... including a medical assessment, if necessary, at no cost to the parents if the district suspects that the student has a disability that would result in Section 504 eligibility. A district must look at more than the student’s grades, and should not rely on the unilateral assessment of a principal ...
[DOCX File]REQUEST FOR SECTION 504 EVALUATION
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Section 504 Eligibility Review Form (Prior to evaluation for 504, written parent/guardian consent must be obtained. Form 504-1 should be used for this purpose) Purpose of Evaluation. At an initial referral for Section 504 plan consideration within MTSS/PBIS interventions. Every three years or sooner for students with existing Section 504 Plans
[DOC File]Medical Statement for Students with Special Nutritional Needs
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Medical Statement for Students with Special Nutritional Needs for School Meals. When completed fully, this form gives schools the information required by the U.S. Department of Agriculture (USDA), U.S. Office for Civil Rights (OCR), and U.S. Office of Special Education and Rehabilitative Services (OSERS) for meal modifications at school.
[DOC File]Section 504 Plan Referral Checklist
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Date of Initial 504 Plan:_____ Section 504 School Coordinator:_____ Indicates forms which need to be mailed to parents prior to the meeting Assessment Checklist Form 2 Original in file: _____ Yes _____No
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