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Extended School Year (ESY) Services Eligibility Form
About this free form template

Streamline ESY Eligibility Decisions with Paperform

Determining Extended School Year (ESY) services eligibility requires careful documentation of regression patterns, recoupment periods, and student progress data. This Extended School Year Services Eligibility Form template helps special education coordinators, IEP teams, and school administrators collect comprehensive information to make informed ESY placement decisions.

Built specifically for special education programs, this form captures critical data including baseline skill levels, regression/recoupment documentation, progress monitoring on IEP goals, and individualized summer program recommendations. Whether you're a special education director managing multiple students or a case manager preparing for IEP meetings, this template ensures all necessary information is documented systematically.

Paperform makes it easy to customize this template to match your district's specific ESY criteria and compliance requirements. Add conditional logic to show different questions based on disability categories, embed video clips or work samples as evidence, and use calculations to automatically flag students meeting ESY thresholds. With Paperform's secure data collection and Stepper workflow automation, you can route completed assessments to IEP team members for review, trigger follow-up tasks for summer program coordinators, and maintain organized records for compliance audits—all without managing spreadsheets or email chains.

The form integrates seamlessly into your existing special education workflows, connecting with student information systems, Google Workspace for collaboration, and communication tools to keep parents and service providers informed throughout the eligibility determination process.

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