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

Guide to Section 504

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

Section 504 Checklist

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

Parental Consent Form

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

Medical Release 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

Eligibility Form

Helpful resource for determining eligibility for 504 services

Manifestation Determination Guide

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

504 Plan Template

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

*504 Plan Without Demographic Information

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

Teacher Input Form

Allows teachers to give meeting input without attending

Student Accommodation Request Form (SAR)

Directions for Completing SAR Form

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

State Documents

DE Special Education Withdrawal Letter

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

Diet Modification Request Form

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

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

Iowa Department of Education

Forms & Processes