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PCESC - Putnam County Educational Service Center

124 Putnam Parkway Ottawa, OH
419-523-5951 Contact Us

Putnam County Educational Service Center

Quick Links

Downloadable Forms

AOC Forms

Gifted Identification Referral Form
- Putnam County Gifted Identification Referral Form
- Putnam County Gifted WEP template

Office Documents

Special Education
- Link to Ohio Required Forms on www.EdResourcesOhio.org
  
  Annotations for Services Plan form Annotations for IEP PR-07 form Form PR-01: Prior Written Notice to Parents Form PR-02: Parent Invitation Form PR-03: Manifestation Determination Review Form PR-04: Referral for Evaluation Form PR-05: Parent Consent for Evaluation Form PR-06: Evaluation Team Report (ETR) Form PR-07: Individualized Education Program (IEP) Form PR-09: Services Plan (SP)
- Link to Ohio Optional Forms (Including Attempts to Obtain Parent Participation)
  
  Form OP-1: Functional Behavior Assessment Form OP-2: Behavior Intervention Plan Form OP-3: Manifestation Determination Form OP-4: Agreement to Waive Reevaluation Form OP-5: Parent/Guardian Excusal Form OP-6: Progress Report Form OP-7: Assignment of a Surrogate Parent Form OP-8: Summary of Performance Form OP-9: Attempts to Obtain Parent Participation
- 504 Accomodation Plan - Word
- 504 Accomodation Plan - PDF
- Compliance Flowchart
- Consent for Agency Participation
- Checklist for Newly Enrolled Special Ed. Student
- EMIS Data Collection Tool for Students with Suspected/Identified Disabilities
  
  1 – Master Code Sheet; Revised 08/31/2016
- EMIS Data Collection Tool for Students with Suspected/Identified Disabilities
  
  2 – EMIS Form; Revised 02/06/2017
- EMIS Data Collection Tool for Students with Suspected/Identified Disabilities
  
  3 – Sample EMIS Forms
- ETR PR-06
- ETR Planning Form
- ETR Re-eval Data Form
- ETR Observation Form
- Eye Exam Summary
- Eye Exam Tracking Form
- IEP Meeting Checklist
- Intervention Specialists List 2019-19
- Medicaid Acknowledgement Letter
- MSB Prescription Form
- Parent/Guardian/Student Consent for Records Release
- Parent Notification of Scholarship Programs for Students with Disabilities
- Related Services Schedule (includes OT, PT, visually/hearing-impaired) for 2016-17
- School-Based Medicaid Q & A
- Speech Therapy Schedule 2018-2019 School Year
- Summary of Performance Resources
- Work/Study Monthly Report - PDF
- Work/Study Monthly Report - Excel

Special Education Resources

Parent Rights SE Guides
- Blank
- Columbus Grove
- Continental
- Jennings
- Kalida
- Leipsic
- Miller City
- Ottawa Glandorf
- Ottoville
- Pandora Gilboa