School SPECIAL STUDENT SERVICES TRACKING LOG Date Submitted Supervisor Referral Type Key: I: Initial, DPR: Direct Parent Referral Psychologist List each student referred to the psychologist for evaluation. EPS All initial (I) referrals and direct parent referrals (DPR) are due in 60 calendar days. for or in in PDR) (60 Age/ IEP Student Name Case Manager days 2102 of Grade and Date Eligibility Date Meeting Meeting building Building Date Eligibility Eligibility Date Categories Due Received received Category IEP Psychological Calendar Initials Reasons Late Exceptions for Initials Student Delays - excessive absences Student enrolls from another district with eligibility already expired Parent Delays - canceling meetings, not providing relevant information in a timely manner Teacher Delays- teachers not following through Exceptions for Initials Evaluator Delays - lack of psychologist, diagnosticians, or speech pathologists Parent repeatedly fails or refused to produce child for evaluation System Errors - no tracking system in place, errors in tracking, error in policies and procedures Extenuating circumstances: e.g. illness, unusual evaluation needs, or parent Other: explain on separate sheet revokes consent for evaluation Child enrolls in a school from another system with the 60 day timeframe in process and the parents have agreed to a different timeline
School SPECIAL STUDENT SERVICES TRACKING LOG Date Submitted Supervisor Referral Type Key: I: Initial, DPR: Direct Parent Referral Psychologist List each student referred to the psychologist for evaluation. EPS All initial (I) referrals and direct parent referrals (DPR) are due in 60 calendar days. Student Name Age/ Grade Case Manager Date 2102 received in building IEP Eligibility Meeting Due Date (60 Calendar days for Initials and PDR) Date Psychological Received in Building Date of IEP Eligibility Meeting Eligibility Category or Categories Reasons Late Student Delays - excessive absences Parent Delays - canceling meetings, not providing relevant information in a timely manner Teacher Delays- teachers not following through Evaluator Delays - lack of psychologist, diagnosticians, or speech pathologists System Errors - no tracking system in place, errors in tracking, error in policies and procedures Other: explain on separate sheet Exceptions for Initials Student enrolls from another district with eligibility already expired Exceptions for Initials Parent repeatedly fails or refused to produce child for evaluation Extenuating circumstances: e.g. illness, unusual evaluation needs, or parent revokes consent for evaluation Child enrolls in a school from another system with the 60 day timeframe in process and the parents have agreed to a different timeline