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Sample School Plan

You may want to give the teacher a copy of your child's treatment plan to keep with this school plan. Adapt this form to fit your child's needs. Keep a copy of the completed form for your records and give a copy to your child's teachers.

Name: __________________________

School year: _____________________

My child's evaluations indicate that he or she needs the following classroom, test, or homework accommodations:

Sample: My child needs extra time to take a written test.







My child needs the following assistance (a study partner, tutor, study skills training). Sometimes school systems provide some of these services.


We are helping my child control the following behavior:


Please use the following consequence to help us control that behavior:


Other concerns I have about my child's learning experiences:


Credits

Current as of: February 9, 2022

Author: Healthwise Staff
Medical Review:
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Louis Pellegrino MD - Developmental Pediatrics

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