Forms & Processes

These forms and resources have been developed to assist parents and educators in determining eligibility for 504 services and addressing 504 requirements.

Heartland AEA Documents

Informative brochure which is often used by districts to notify parents of their rights under Section 504 and serve as second notice.

Guide to Section 504

A step-by-step guide through the 504 process of identification to eligibility determination to plan revision.

Section 504 Checklist

Form to obtain parental consent prior to evaluation for 504 eligibility and notice of parental rights.

Parental Consent Form

Iowa Department of Education release form modified with their consent to serve for Section 504; district letterhead may be placed at the top of the forms.

Medical Release Form

Helpful resource for determining eligibility for 504 services.

Eligibility Form

An optional form that districts may use if they don’t have their own.

Manifestation Determination Guide

A blank 504 plan template that districts may use to write student plans.

504 Plan Template

*Extra page to add to 504 plan template without demographic information at the top.

*504 Plan Without Demographic Information

Allows teachers to give meeting input without attending.

Teacher Input Form

Required form for graduating students with 504 plans attending post-secondary education and directions for completing the form.

Student Accommodation Request Form (SAR)

Directions for Completing SAR Form

State Documents

Iowa Department of Education guidance for parents who withdraw children from special education and demand Section 504 plans.

DE Special Education Withdrawal Letter

Iowa Department of Education form to assist districts/schools in noting substitutions in meals for students who are considered to have a disability as defined by Section 504 or the Americans with Disability Act.

Diet Modification Request Form


For additional information on Section 504 requirements in Iowa, visit:

Iowa Department of Education

Forms & Processes