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Data Collection Form

The Data Collection form is a tool in SEEDS4Schools used to communicate changes that occurred during the event through the IEP meeting. These changes include placement, meeting dates, impairments, services, environmental codes, and enrollments. The Data Collection form will pull dates from forms that exist within that event if the forms are saved in final form, so there is no need to hand enter dates. Click on this link, while you are logged into SEEDS4Schools, to see where the prefilled data originates from. Please note the fields which are highlighted in the shared images, these fields will be referenced in the III Summary section.


The following is a brief description of the data being collected:

Student / Parent Section

The information in this section comes from the Student Detail View. This information should be verified to ensure the accuracy of the data on the Student Detailed View. If there are changes, please notify the person who updates your district’s information in SEEDS4Schools. 

I. Evaluation/IEP tab

EVALUATION INITIATION DATE & OUTCOME OF EVALUATION INFORMATION

This section is to collect data for information regarding evaluations. 

  1. Evaluation Type: Initial Evaluation Initiated
  2. (A-1 Referral) Signed Date:
    The actual date signed by the LEA.
  3. (A-3 Notice and Consent Regarding Need to Conduct Additional Assessments)
    Sent Date: The date the A-3 was sent. (This date will prefill from the A-3 form date)
  4. (A-3 Notice and Consent Regarding Need to Conduct Additional Assessments)
    Signed Date: The actual date the parent signed for consent.
  5. (A-3 Notice and Consent Regarding Need to Conduct Additional Assessments)
    Received Date: The date in which the consent is received in the district.
  6. (A-3 Notice and Consent Regarding Need to Conduct Additional Assessments)
    Refused Consent Date: The date in which the consent was refused.
  7. (A-4 Notice That No Additional Tests Needed for Evaluation)
    Sent Date: The date the A-4 was sent. (This date prefills from the A-4 Form Date)
  8. (A-6 IEP Team Evaluation Report including Eligibility Determination) Meeting Date:
    (This date prefills from the A-6 meeting date)
  9. (I-4 Parent Consent for Placement) Date:
    The date the I-4 was signed for consent or rejection of placement. (This date prefills from the I-4 Date)
  10. Parent Consent for Placement? Select Yes/No if the parent signed consent for placement.
  11. Impairment? Documents if the team decided the student has an impairment or not.
  12. Need for Special Education:
    Yes, Enroll -
    The team determined the student has a need for special education and needs to be enrolled on a class and/or itinerant list
    Yes, Do Not Enroll -
    The team determined the student has a need for special education but does not need to be enrolled on a class and/or itinerant list
    No -
    The team determined the student does not have a need for special education
  13. Evaluation Type: Re-evaluation Initiated
    Additional field for this option is 
    (A-2 Notice of Receipt of Referral or Notice of Reevaluation) Date: The date the A-2 was sent. (This will prefill from the A-2 form date)
  14. Evaluation Type: Re-evaluation Not Needed
    Additional field for this option is 
    (A-2S Notice of Agreement 3 Yr Reeval Not Needed) Date: The date in which the parent was contacted to determine no evaluation was needed. (This will prefill from the A-2S form date) 
  15. N/A: There was not an evaluation included in the meeting/event.

IEP INFORMATION ONLY 

The IEP Information Only section collects dates from IEP or Service Plan meetings.

  1. Meeting Type: Annual IEP
  2. Annual Meeting Date: The date the meeting was held.
  3. Implementation Date: The implementation is the date in which the IEP will be implemented.
  4. Ending Date: Is the last day of the IEP
  5. Meeting Type: Review/Revise IEP 
    Date fields: Meeting Date, Implementation Date, Ending Date
  6. Meeting Type: Service Plan
    Date fields: Service Plan Meeting Date, Implementation Date, Ending Date
  7. Meeting Type: IEP Meeting Not Held, Changes Made
    Date fields: Meeting Date, Implementation Date, Ending Date
  8. N/A: There was not an IEP type meeting included in this meeting/event.

IMPAIRMENT INFORMATION

  1. Select the Primary Disability for the student
  2. Select Secondary Impairment(s) for the student
  3. Select the Related Service(s) for the student
  4. Select the Program of Adaptive Physical Education for the student if appropriate

ENVIRONMENTAL CODES

SEEDS4Schools will give the Educational Environment code options according to the student's age. The Educational Environment calculator helps to determine the correct code for the student. 

  1. In this example, the student is 5 years old and the Data Collection form will give the > 6-year-old Environmental Codes available for students of that age.
  2. The green question mark is a link to DPI's Educational Environment page.
  3. This drop-down has Child Attends Any General Education (i.e. Preschool, Head Start, Day Care): options.
  4. This drop-down has Child Attends Only Special Education: options.
  5. This question will bring up the >6 environment codes when it is answered Yes
  6. Time in special education calculator: Possible Minutes School is in Session in a Week:
  7. Time in special education calculator: Total Minutes in Special Education Per Week:
  8. Time in special education calculator: Total Minutes in Related Services Per Week:
  9. The green Calculate link will calculate the % of the child's time is spent in General Education
  10. This drop-down has 

II Enrollments

Classlist Information

  1. Teacher Name / Service Provider: The name of the teacher or service provider needs to be entered. (If Related Services is checked on the IEP, the service will prefill.)
  2. Type: Determines if the services are new, continued, dropped or an eval only
  3. Enter Date: List the IEP Implementation Date (not meeting date) in this column
  4. Exited Date: Date of the last day the student received services or was dismissed from the classroom
  5. Current Amount and Frequency for Itinerant Services: The amount and frequency of itinerant as documented on the I-3 will prefill here. (This column only needs to be completed for Itinerant Services)
  6. (CESA STAFF ONLY) Units of Service: Projected Annual Units of Service are the units that the itinerant was expected to service the student. Actual Units of service are the units that the student was serviced. Evaluation only units are for students who will not receive services.
  7. (CESA STAFF ONLY) Membership and Attendance: Days of Membership are the total number of days a student could have been in attendance in the district. Days of Attendance are the total number of days the student actually attended in the district. 
  8. Add Another: is used to create another row of fields for additional services.

 

  1. Select WISEdata Exit Reason if the student is physically moving out of the district, max age, graduation or has died.
  2. The green question mark is a link to DPI's Exit Reasons page
  3. If Exit Reason is TC, enter the continuing district here: Enter the name of the district the student is continuing in
  4. Check this box is the student is going to Return to General Ed
  5. Add the date the student was dismissed from special education
  6. Check this box if the consent was revoked by the parents or adult student
  7. Comments: Any information that needs to be documented for further understanding.
  8. If Early Childhood Placement: Check the appropriate box if the student attends Early Childhood.

    CHILD INFORMATION:

  9. Birth to 3 Referral – Check this box is the student is a Birth to 3 Referral. The Birth to 3 report pulls student’s who have this box checked.
  10. Private School Child receiving special education – Name of Private School – Check this box if the student is attending a Private School. Please fill in the Name of the Private School
  11. The Child is placed under Open Enrollment Provision – District of Residence – Check this box is the student is attending the District under “Open Enrollment”, please also list the District of Residence.

III Summary

 Review Process

  1. Select the staff member(s) which an email will be sent to which includes a link to this data collection form for review.

    DIRECTOR USE ONLY

  2. Name of the person reviewing this Data Collection Form
  3. Date the form was reviewed
  4. Add necessary notes intended for the staff updating the information in SEEDS.

    SECRETARIAL USE ONLY
  5. Date the information was updated in SEEDS and the initials of the staff who updated it
  6. Check off the data which was updated
  7. Add necessary notes
  8. Update Student Detail View - selecting this checkbox will update the information from the highlighted fields on this Data Collection form to the fields on the Student Detail View. When the green question mark is clicked, it lists the fields which are updated.


 

 

 

 

 

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