Section and Fields in the EDR form

Student Name

Name of the student for whom the meeting has been called.

No

Yes

Student Information

N.A.

Populated from Student Information Profile. Captured through the {StudentName} field.

ID

Student ID as per the Student Information System records.

No

Yes

Student Information

N.A.

Populated from Student Information Profile.
Captured through the {stateid} or {ID} field.

Date of Birth

DOB of the student as per the Student Information System records.

No

Yes

Student Information

N.A.

Populated from Student Information Profile.
Captured through the {BirthDate} field.

Age

Age of the student as of the birth date.

No

Yes

None

N.A.

Calculated as per the current date and DOB. Captured through the {AgeInYearsMonths} field.

Grade

The academic grade the student is enrolled in or would be enrolled in.

No

Yes

Student Information

N.A.

Populated from Student Information Profile.
Captured through the {Grade} field.

School/Site

The name of the School the student is enrolled in or would be enrolled in.

No

Yes

Student Information

N.A.

Populated from Student Information Profile.
Captured through the {School} field.

List of disabilities displayed to choose from:

• Autism

• Deaf-Blindness

• Emotional Disturbance

• Hearing Impairments

• Intellectual Disability

• Multiple Disabilities

• Orthopedic Impairments

• Other Health Impairments

• Preschool Disabled (Non-Categorical)

• Specific Learning Disabilities

• Speech/Language Impairments

• Traumatic Brain Injury (TBI)

• Visual Impairments

This field contains the student's special education eligibility category.

One of the disabilities must have been pre-selected.
And data here flows from the Special Education Information Profile, Disability field.

No

Yes

Special Education Profile

N.A.

Populated from the Special Education Information Profile, Disability field.
Captured through the {Disability} field.

After being captured by the {Disability} field, each disability is identified by a unique keyword as mentioned in the following list.

• Autism (AU)

• Deaf-Blindness (DB)

• Emotional Disturbance (ED)

• Hearing Impairments (HI)

• Intellectual Disability (MRID)

• Multiple Disabilities (MD)

• Orthopedic Impairments (OI)

• Other Health Impairments (OHI)

• Preschool Disabled (Non-Categorical) (PS)

• Specific Learning Disabilities (SLD)

• Speech/Language Impairments (SI)

• Traumatic Brain Injury (TBI)

• Visual Impairments (VI)

Achievement Data

.

Summarizes the student’s performance on academic tasks over time. Helps determine current skill levels and progress toward grade-level expectations.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {AchievementDataCB} field.

Medical Records

Captures relevant health information that may impact learning or behavior. Used to understand medical factors influencing the student’s educational needs.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {MedicalRecordsCB} field.

Adaptive Behavior

Describes daily living, social, and functional skills. Helps evaluate how independently the student manages age-appropriate tasks.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {AdaptiveBehaviorCB} field.

Occupational Therapy Data

Covers fine motor, sensory, and functional school-based OT assessments. Used to determine if OT support is needed.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {OccTherapyCB} field.

Anecdotal Records

Record of Teacher or staff observations recorded informally. Provides insight into patterns of behavior, engagement, or performance.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {AnecdotalRecordsCB} field.

Orientation and Mobility Data

Information on the student’s ability to move safely and independently in school environments. Primarily relevant to students with visual impairments.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {OrientationMobilityCB} field.

Assistive Technology Data

Provide details on the tools or devices used to support access to the curriculum. Helps identify AT needs or evaluate the effectiveness of existing supports.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {AssistiveTechnologyCB} field.

Physical Therapy Data

Covers the records of assessments related to gross motor strength, mobility, and physical access in school. Used to determine PT service needs.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {PhysicalTherapyCB} field.

Attendance Records

Documents absences, tardies, and attendance patterns. Helps determine whether attendance impacts academic performance or behavior.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {AttendanceRecordsCB} field.

Portfolio/Current Work Samples

Covers the record of examples from the student’s recent classwork. Provides evidence of current academic functioning.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {PortfolioCB} field.

Behavior Scales

.

Standardized behavior rating tools are completed by teachers or caregivers. Used to assess emotional, social, or behavioral concerns.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {BehaviorScalesCB} field.

Previous Psychological Evaluation

Reports from earlier psychoeducational assessments. Provides historical context for cognitive, academic, or behavioral profiles.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {PrevPsychologicalEvalCB} field.

Behavioral Intervention Plan

Current or past BIPs outlining strategies and supports. Shows how behavior has been addressed and the success of interventions.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {BIPCB} field.

Previous Services Received (Special Education, 504, ESOL, etc.)

This would include records of Special Education, 504, ESOL, etc.
Records of earlier support services. Helps track what interventions have been tried and their outcomes.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {PrevServicesReceivedCB} field.

Classroom-Based Assessments

Teacher-created tests, quizzes, and performance tasks. Reflects how the student performs on day-to-day instructional measures.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {ClassBasedAssessmentCB} field.

Progress and Grade Reports

Updates on academic progress and grades across subjects. Helps track achievement trends over time.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {ProgressGradeCB} field.

Classroom Observation

Structured observation of the student during instruction or activities. Provides real-time insight into engagement, behavior, and learning.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {ClassroomObservationCB} field.

Self-Help Skills

Information on personal care, independence, and daily routines. Helps assess how well the student manages practical life skills.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {SelfHelpCB} field.

Current Eligibility Information

Details the student’s existing disability category and service plan. Provides the starting point for continued eligibility review.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {CurrentEligiInfoCB} field.

Social History Update

Background information on family, cultural, developmental, and environmental factors. Helps understand influences on learning and behavior.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {SocialHistoryUpdtCB} field.

Curriculum-Based Assessments

Direct assessments linked to the classroom curriculum. Measures student skills relative to instructional content.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {CurriBasedAssessCB} field.

Speech-Language Data

Evaluations of communication skills, including speech, language, and pragmatic abilities. Determines whether communication impacts learning.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {SpeechLangCB} field.

Discipline Records

Documented behavior incidents and consequences. Helps identify patterns or areas needing intervention.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {DisciplineRecordsCB} field.

Teacher/Staff Observations

Input from staff who interact regularly with the student. Captures functional pe

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {TeacherObserveCB} field.

Hearing/Vision Screening/Data

Records of all the screening results indicate whether sensory issues affect learning. Used to rule out hearing or vision as primary concerns.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {HearingScreeningCB} field.

Transition Plan

Outlines goals and supports for post-school readiness. Applies mainly to older students preparing for adult life.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {TransitionPlanCB} field.

IEP Accommodations

Details accommodations currently provided to support learning. Helps determine effectiveness or need for changes.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {IEPAccommodationsCB} field.

IEP Goals and Objectives

The student’s existing goals and progress toward them. Helps evaluate growth and guide future planning.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {IEPGoalsCB} field.

Information Provided by Parents

Input from parents or guardians on strengths, needs, and concerns. Ensures the family perspective informs decision-making.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {InfoByParentsCB} field.

Local or State Assessments

Scores from district or statewide standardized tests. Provides objective data on academic achievement.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {LocalStateAssessCB} field.

Other Data

Any additional relevant information not included in standard categories. Added based on individual student needs.

Yes

No. Conditional. One or many from this list can be selected

N.A.

N.A.

Captured through the {OtherDataCB} field. The response to this field is further collected through (Specify): {OtherText:H1}.

Present levels of performance and educational needs of the child (e.g., transition and postsecondary planning)?

Choose between Yes and No.

• If ‘Yes’ is selected, the workflow proceeds to ‘Section A’.

• If ‘No’ is selected, the workflow proceeds to ‘Section B’.

Yes

Yes

N.A.

N.A.

Based on your selection, the response is captured as follows:

• For Yes {PresentLevelCB:+} 

• For No {PresentLevelCB:-}

Whether the child is a child with a disability or, in case of a reevaluation, whether the child continues to have such a disability?

Choose between Yes and No.

• If ‘Yes’ is selected, the workflow proceeds to ‘Section A’.

• If ‘No’ is selected, the workflow proceeds to ‘Section B’.

Yes

Yes

N.A.

N.A.

Based on your selection, the response is captured as follows:

• For Yes {ChildDisabilityCB:+} 

• For No {ChildDisabilityCB:-}

Whether the child needs special education and related services or, in case of a reevaluation, continues to need special education and related services?

Choose between Yes and No.

• If ‘Yes’ is selected, the workflow proceeds to ‘Section A’.

• If ‘No’ is selected, the workflow proceeds to ‘Section B’.

Yes

Yes

N.A.

N.A.

Based on your selection, the response is captured as follows:

• For Yes {ServicesCB:+} 

• For No {ServicesCB:-}

Whether any additions or changes to the special education and related services are needed to meet IEP goals and participate, as appropriate, in the general curriculum?

Choose between Yes and No.

• If ‘Yes’ is selected, the workflow proceeds to ‘Section A’.

• If ‘No’ is selected, the workflow proceeds to ‘Section B’.

Yes

Yes

N.A.

N.A.

Based on your selection, the response is captured as follows:

• For Yes {GeneralCurriculumCB:+} 

• For No {GeneralCurriculumCB:-}

Evaluation/reevaluation in order to determine eligibility or continued eligibility.

If this option is selected, you must further select (One or more disabilities) from the list displayed under the heading “The committee determined evaluation data for the following assessment areas are needed. “

• Vision screening

• Hearing screening

• Social/Developmental History

• Education History/Records

• Individual Intelligence/Cognition

• Achievement/Developmental Performance

• Adaptive/functional behavior (Self-help)

• Communicative Abilities

• Behavior

• FBA

• Observation

• Processing

  • Visual

  • Auditory

• Medical information >>> Needs additional long-text details upon selection.

• Other >>> Needs additional long-text details upon selection.

Yes

No.

N.A.

N.A.

Captured through the {EligibilityCB} field.

Further, based on your selection, the response for selecting the disability is captured through the following fields:

• {EvalVisionScr}

• {EvalHearingScr}

• {EvalSocialDevel}

• {EvalEducHist}

• {EvalIndivIntel}

• {EvalAchieveDevel}

• {EvalAdaptFunc}

• {EvalCommAbil}

• {EvalBehavior}

• {EvalFBA}

• {EvalObservation}

• {EvalProcessing}

  • {EvalVisual}

  • {EvalAuditory}

• {EvalMedicalInfo}

  • {EvalMedicalInfoText}

• {EvalOtherArea}

  • {EvalOtherAreaText}

Reevaluation to consider new/additional eligibility.

This option can be selected independently or along with the previous option.

If this option is selected, you must further select one of the following:

• Vision screening

• Hearing screening

• Social/Developmental History

• Education History/Records

• Individual Intelligence/Cognition

• Achievement/Developmental Performance

• Adaptive/functional behavior (Self-help)

• Communicative Abilities

• Behavior

• FBA

• Observation

• Processing

  • Visual

  • Auditory

• Medical information >>> Needs additional long-text details upon selection.

• Other >>> Needs additional long-text details upon selection.

Yes

No. But selection is conditional.

N.A.

N.A.

Captured through the {EligibilityReevalCB} field.

• {EvalVisionScr}

• {EvalHearingScr}

• {EvalSocialDevel}

• {EvalEducHist}

• {EvalIndivIntel}

• {EvalAchieveDevel}

• {EvalAdaptFunc}

• {EvalCommAbil}

• {EvalBehavior}

• {EvalFBA}

• {EvalObservation}

• {EvalProcessing}

  • {EvalVisual}

  • {EvalAuditory}

• {EvalMedicalInfo}

  • {EvalMedicalInfoText}

• {EvalOtherArea}

  • {EvalOtherAreaText}

Reevaluation to gather information to aid in instructional planning.

This option can ‘Only be selected' if the previous option has already been selected.

Yes

Conditional

N.A.

N.A.

Captured through the {InstructionalCB} field.

Child meets IDEA eligibility or, in the case of a reevaluation, continues to meet IDEA eligibility in a category of

If selected, you must further select one of the following:

• Autism (AU)

• Deaf-Blindness (DB)

• Emotional Disturbance (ED)

• Hearing Impairments (HI)

• Intellectual Disability (MRID)

• Multiple Disabilities (MD)

• Orthopedic Impairments (OI)

• Other Health Impairments (OHI)

• Preschool Disabled (Non-Categorical) (PS)

• Specific Learning Disabilities (SLD)

• Speech/Language Impairments (SI)

• Traumatic Brain Injury (TBI)

• Visual Impairments (VI)

Yes

Conditional

N.A.

• Special Education profile

• Disability History profile

• Eligibility History profile

Captured through the {IDEAEligibleCB} field.

Once the Disability is selected, it is captured through the {DisabilityDD} field.

Child does not meet IDEA eligibility or, in the case of a reevaluation, does not continue to meet IDEA eligibility.

Yes

Conditional

N.A.

• Special Education Disability Profile

• Disability History child profile

Also, the fields Eligibility Status and Eligibility Determination Date flow to the Special Education profile.

Captured through the {IDEAEligibleNotCB} field.

Data flows from Disability Profile.

Parent was notified of the decision and their right to request additional assessment.

Choose between Yes and No.

Yes

Conditional

N.A.

N.A.

Captured through the {ParentNotifiedCB} field.

Excusal(s)

Are Excusals allowed? Choose between Yes and No.

• If you have chosen ‘Yes’, then you must respond to the following three fields:

  • Name(s) of Team Member(s) Excused

  • Parent Agreement to Excusal

  • Is the excused member's area of curriculum being discussed?

• If you have chosen ‘No’, you can skip the three fields (which are disabled) and proceed directly to the EDR Committee list.

Yes

Yes

N.A.

N.A.

Captured through the {ExcusalCB} field.

Name(s) of Team Member(s) Excused

Here, you are allowed to mention one or more names of people who, though necessary for the decision-making process, will now be excused from participating.

• You can add multiple entries using the icon. under the heading ‘Name(s) of Team Member(s) Excused’.

• For every additional entry, a new row will appear.

Yes

Conditional

Staff Profile.

N.A.

Captured through the {^ExcusedMem:R} field.

Parent Agreement to Excusal

Choose between Yes and No.

If choosing ‘Yes’ under Excusal(s), then add the signature of the parent.

If the document is being signed digitally and Excusals is ‘Yes’, then the system displays each parent/guardian name, and you must check one of the names in order to set the document to review.

• Only one parent/guardian name will be permitted to be checked.

• Once the document is sent digitally to the parent or Guardian, the parent/guardian who has the name checked must check 'yes' or 'no' and must initial.

Yes

Conditional.

If “Sign Paper Copy” is selected, then this field is disabled.

N.A.

N.A.

Based on your selection, the response is captured as follows:

• For Yes {AgreeDisagreeCB}

• For No {AgreeDisagreeCB:R} 

Further, if you select ‘Yes’ for allowing Parental Excusal, then the signature is captured through the {ParentESignCB} field.

Is the excused member's area of curriculum being discussed?

Choose between Yes and No.

Yes

Conditional. Allowed only if Excusals is ‘Yes’.

N.A.

N.A.

Based on your selection, the response is captured as follows:

• For Yes {ExcuseCurriculumCB:+} 

• For No {ExcuseCurriculumCB:-}

Parents / Guardian

• You can add multiple entries under the heading ‘Parents or Guardians’.

• To add an additional entry, click the icon and a new row will appear.

Yes

Yes

Student Contacts profile

Document Delivery Profile

Captured through the {^ParentSign} field.

Special Education Teacher

• Use Lookup or Non-Lookup to select the Special Education Teacher from the Staff Profile.

• After selection, the teacher must sign the document. The system records their signature, date, and time stamp.

Yes

Yes

Staff Profile

N.A.

Captured through the {SpecialEdTeacher},
{SpecialEdESign}, and
{SpecialEdTeacherDate} fields.

General Education Teacher

• Use Lookup or Non-Lookup to select the General Education Teacher from the Staff Profile.

• After selection, the teacher must sign the document. The system records their signature, date, and time stamp.

Yes

Yes

Staff Profile

N.A.

Captured through the {GeneralEdTeacher}, {GeneralEdSign}, and {GeneralEdDate} fields.

Local Education Agency Representative

• Use Lookup or Non-Lookup to select the LEA Representative from the Staff Profile.

• After selection, the representative must sign the document. The system records their signature, date, and time stamp.

Yes

Yes

Staff Profile

N.A.

Captured through the {LEATeacher}, {LEAESign}, and {LEADate} fields.

Individuals to Interpret Instructional Implications of Evaluation Results

• Use Lookup or Non-Lookup to select the Interpreter from the Staff Profile.

• After selection, the interpreter must sign the document. The system records their signature, date, and time stamp.

Yes

Yes

Staff Profile

N.A.

Captured through the {Interpreter}, {InterpreterESign}, and {InterpreterDate} fields.

Others

• You can add multiple entries under the heading ‘Others’.

• To add an additional entry, click the icon and a new row will appear.

Yes

No

N.A.

N.A.

Captured through the {^OthersRole } field.

Date

Yes

Yes

N.A.

N.A.

Captured through the {DeterminationDate} field.

In a conference

Yes

Conditional.

N.A.

N.A.

Captured through the {MeetingLocationCB:+) field.

Through consultation with the required committee members

Yes

Conditional

N.A.

N.A.

Captured through the {MeetingLocationCB:-) field.

Mode of Delivery

The method used to send the document to the parent.

Yes

Yes

N.A.

Document Delivery Profile

Captured through the {DeliveryMethod) field.

Date of Delivery

The date on which the document was dispatched to the parent.

Yes

Yes

N.A.

Document Delivery Profile

Captured through the {DateProvided} field.

Details 

To Profile