Alternative Dispute Resolution (ADR)

View and/or download the ADR Brochure

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ADR Services Brochure (English)

Request ADR Services

ADR Request Form
 
The parent/guardian or school district can initiate the Alternative Dispute Resolution (ADR) process by completing and submitting this form to the Desert/Mountain Special Education Local Plan Area (SELPA). Both the parent/guardian and school district can also jointly submit the request form. The Desert/Mountain SELPA will review the request and respond to the parties.
 
The ADR is requested by:  Parent/Guardian    School District    Both Parent/Guardian and School District
Requestor's e-mail address:
    
Parent/Guardian Name: District Administrator: 
Contact Number:
Contact Number:
E-mail Address:
E-mail Address:
Attending School Site:
School District:
 
Areas of concern:
 Accommodations/Modifications   Assistive Technology   Behavior/Discipline   Extended School Year
 Goals/Objectives    Identification/Reevaluation    IEP Implementation   Independent Educational Evaluation
 Placement   Present Levels of Performance   Progress Reporting   Related Services
 Transition    Other: 
 
Briefly describe the issue. (NOTE: Please DO NOT include the child and/or student's personal data such as name, DOB, etc.)
 
Have you contacted anyone at the school district regarding the issue described above?  Yes  No
 
If yes, please desribe the outcome of that conversation. (NOTE: Please DO NOT include the child and/or student's personal data such as name, DOB, etc.)
 
Describe the steps the school district has taken to resolve the issues described above.
 
BY INDICATING YOUR NAME BELOW, YOU ARE ACKNOWLEDGING THE FOLLOWING STATEMENTS:
  1. The Alternative Dispute Resolution (ADR) process is a voluntary process.
  2. There will be no cost to the Parent/Guardian or the school district.
  3. The facilitator is not a member of the Individualized Education Program (IEP) team.
  4. The facilitator cannot provide legal advice to any participant.
  5. Your acknowledgement and submission of this request gives the facilitator access to the student information and records during the facilitation process.
Requestor's Name:
Date Submitted: 
 

 



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