This is a sample letter to use to request an Initial Evaluation for Special Education Services. This could result in the form of an Individualized Education Program (IEP) or 504 Plan.  Send this letter to the Special Education Director by certified mail with a return receipt.  Keep a copy for your records. 

(Date)

(Insert name of Special Education Director)
(Insert name of county) County
(Insert address)

(Insert your name)
(Insert your address)

RE:  Request for initial evaluation for special education services 

Dear Mr. or Ms. (Insert Special Education Director’s last name),

     I am the parent of (Insert your child’s full name), a (Insert your child’s grade) grade student at (Insert your child’s school’s name).

     I am writing to request that my son/daughter, (Insert child’s first name) receive a multidisciplinary evaluation for special education services. I am making this request under the Individuals with Disability Education Act (IDEA).  I am worried that (Insert child’s name) is not doing well in school, and believe he/she may have a disability and be eligible to receive special education services through the school.

     Specifically, a few of my concerns are as follows.  (Insert child’s name), cannot (list a few examples of your child’s problems at school)

     I understand that I have to give written permission in order for the testing to begin, please consider this request as written permission.  I would be happy to talk with you about (Insert child’s first name), and answer any question you may have.  You can reach me during the day at (Insert daytime telephone number).  Thank you for your prompt attention to my request.

                                                                        Sincerely,

                                                                        (Sign your name)  

                                                                        (Type your name)

Note: The school district should evaluate your child in several areas such as educational, mobility and intelligence.  Other areas such as a physical/occupational or speech evaluation require you to provide a request from your child’s doctor with this letter. The school district will have eighty (80) days to conduct the evaluations and hold an Eligibility Committee (EC) meeting to review all evaluations and determine your child’s eligibility for special education services.