You are on page 1of 2

504 Plan Accommodations for

Date:

Accommodation Plan:
Note: May consider mitigating circumstances in
determining whether a plan is needed.
Does the student need accommodations to access the
benefits of public education as adequately as the needs of
nondisabled students are met?

Yes

Accommodations/Adaptations

Responsibilit
y

Signature of Team Members

No
Location

Title

Periodic Review: Parent agreement required for Initial 504


plan
Date
Signature of Team
Title
Agre Disagr
Members
e
ee

Agree

You might also like