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Teacher Input Form

This document is a teacher input form for a student's IEP or ER evaluation. It requests the teacher to rate the student in areas like rate of learning, need for repetition, homework, classwork, test results, and attendance. The teacher is also asked to provide specific feedback on the student's academic and behavioral strengths and needs, as well as their study skills and work habits. The completed form will be integrated into a re-evaluation report for the student's parents during a team meeting to review the student's program every three years as required for students in special education.

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297 views1 page

Teacher Input Form

This document is a teacher input form for a student's IEP or ER evaluation. It requests the teacher to rate the student in areas like rate of learning, need for repetition, homework, classwork, test results, and attendance. The teacher is also asked to provide specific feedback on the student's academic and behavioral strengths and needs, as well as their study skills and work habits. The completed form will be integrated into a re-evaluation report for the student's parents during a team meeting to review the student's program every three years as required for students in special education.

Uploaded by

api-299624417
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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TEACHER INPUT FORM IEP/ER

Student:

Grade:

Teacher:

Subject:

Program
:
STUDENT'S GRADE TO DATE:

IEP Teacher of Record:

Due By:

Parent/staff requested that student be evaluated.


Every three years, students in Special Education may have their program re-evaluated. Your information will be integrated
and summarized in a Re-Evaluation Report. The parents will receive the information during a team meeting.

PLEASE RATE THE STUDENT IN THE FOLLOWING AREAS AND RETURN THIS FORM TO:
1. RATE OF RETENTION AND ACQUISITION: Please rate the above student in the following areas and explain.
Rate of acquisition of New Material (check one):
Need for Repetition and Review (check one):

High
Seldom

Average
Occasionally

Low
Frequently

2. AREAS OF CONCERN: Please check only those that apply.

Homework:
Classwork:
Participation:
Behavior
Test Results:
Attendance:

Mild
Mild
Mild
Mild
Mild
Mild

Moderate
Moderate
Moderate
Moderate
Moderate
Moderate

Severe
Severe
Severe
Severe
Severe
Severe

3. STRENGTHS AND NEEDS: Provide specific feedback about the student in each area, academic and behavior.
(e.g. Student struggles with math computation, specifically subtraction with regrouping in triple digit numbers;
Student must be asked an average of four times before following directions.
Academic

STUDY ORGANIZATIONAL SKILLS/WORK HABITS


Indicate s for a strength and w for a weakness
Class preparation
Organizational skills
Homework assignment completion
Classwork completion
Independent work completion
Cooperative/Group work
Accuracy of work completed
Creativity
Meets deadlines
Test taking skills
Other

Behavior

Additional Comments

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