Documente Academic
Documente Profesional
Documente Cultură
DATE: _______/_______/_______
05 15 16 PARENT INITIALS: _______________
NAME: ___________________________________________________________________
CASSANDRA COOLEY GRADE: ___________________________
10
COMPREHENSIVE STUDENT SUPPORT (CSS) - IN LAB SUPPORTIVE STUDENT SERVICES (SSS) - NOT IN LAB
DSPS LAB TEACHER: _____________________________________________
SARA PINICK DSPS CASE MANAGER: ___________________________________________
YES NO DSPS ENGLISH YES NO DSPS HISTORY
DIAGNOSED DISABILITY
Specific Learning Disorder: ADHD (Other Health Impairment):
Reading/Dyslexia _________________________________________ Inattentive Type Hyperactive Type
Math ________________________________________________________ Combined Type
Written Expression _____________________________________ Autism Spectrum Disorder
Dysgraphia (writing or fine motor skills deficit) Other __________________________________________________________
OBESSSIVE COMPULSIVE DISORDER
Visual Impairment ___________________________________________ Medical _______________________________________________________