Appendices
MTSS Forms
Georgia Cyber Academy Medical Form—This form allows parents to disclose diagnoses or medications that are relevant to the student.
Parental Rights —This form explains the rights of the parents regarding special education.
Parent Request for Special Education Notice (PRSN) Response Letter This letter is sent to parents who make a direct parent request for an evaluation. The letter explains the SST process and requires documentation.
PGB SST Form —This form is used to document student data and meeting notes during a SST Tier 3 meeting.
EGB SST Form —This form is used to document student data and meeting notes during a SST Tier 3 meeting.
MGB SST Form —This form is used to document student data and meeting notes during a SST Tier 3 meeting.
SGB SST Form —This form is used to document student data and meeting notes during a SST Tier 3 meeting.
Visual Example of Form 3300 —This form provides a visual example of a completed 3300
504 Forms
College Board Consent Form– The SGB 504 Plan Coordinator will send this form to parent or student if 18+ to complete when accommodations are requested for The College Board.
Diabetes Health Management Plan - This documentation is required for all Section 504
Plans for students with diabetes. The form should be completed by a medical physician.
ACT Consent Form– The SGB 504 Plan Coordinator will send this form to parent or student if 18+ to complete when accommodations are requested for The ACT.
Vocational Rehabilitation Forms - Secondary Grade Band 504 Plan Coordinator or District 504 Plan Supervisor will send these forms to parent or student if 18+ when vocational rehabilitation services are requested.
ESOL Forms
Required Home Language Survey
Parent Waiver of Direct ESOL Services