CERTIFIED MAIL # ___________________


Date


Mr./Ms.  _________________
Special Education Director
________________ Independent School District
Address
City, State  Zip Code

RE:   Name of Child ______________
        Parent referral for multidiscplinary evaluation

Dear Mr/s. _______________________:

Our son/daughter is experiencing academic and/or behavioral problems in school.  S/he is ___ years old and attends ______ School.  It is requested that Child's Name be scheduled for a Full and Initial Evaluation in conjunction with the Individuals with Disabilities Education Act (IDEA) to determine if s/he is eligible for special education and related services.  It's my understanding this is a multidiscplinary evaluation.

Your attention is directed to the attached
"Parent Report." The parent document has been prepared in an effort to convey information that may assist ________ Independent School District in the evaluation process.  

It is also my understanding that there are various timelines involved in the overall IDEA process.  At your earliest convenience, please forward them to me at the address below.

We look forward to receiving an evaluation plan within 10 days of this request.  It will be necessary that we receive a copy of the Full and Initial Evaluation Report together with subtest scores one week prior to the IEP meeting being scheduled.   Depending on the language utilized in the report(s), for clarification purposes, it may also be necessary to schedule pre-IEP meeting(s) with the diagnostician(s) and other evaluator(s).

This letter is parent consent for the evaluation.  If additional information is needed, please contact me immediately. 

Sincerely,

Your Name
Address
Telephone number

Cc:  Mr/s._____________ ,   ______________ISD Superintendent

Attachment
Parent Referral for Special Education Evaluation sample letter:
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Updated 07-19-03