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Sample IEP & Letters
School Advocacy & Education Support
Welcome! Listed below, parents, educators and physicians can find samples and templates of commonly used documents that can aid mitochondrial disease-affected patients and families in expressing and advocating their concerns for educational supports. These documents were formulated with the best of intentions; and there may be some areas that do not apply to your child(ren).
Please note that these templates are ONLY suggestive documents and that the contents of the documents are formatted to ease discussions with primary care physicians, specialists, and educators. These documents offer a means to better communicate at office visits or to school personnel the complexities that may arise when attempting to convey your child's particular presentation of mitochondrial symptoms, and how they are affecting their academic school performances.
It is IMPERATIVE that the implementation and acceptance of these documents have a physician's signature, proper school district personnel signatures, as well as the parent's signatures to be used and accepted by your child's school.
If there is a template you feel would be helpful, please feel free to send them to me at firstname.lastname@example.org
Children and young adults who live with mitochondrial disease should have the opportunity to thrive in the most supportive environment possible, both at home and in their school setting.
MitoAction is committed to helping educators, teachers, and therapists in your community understand how mitochondrial disease might affect your child or teen, and to offer constructive ideas to help modify the school setting to best meet his or her needs.
Tools for School Success
- Sample IEP (Individualized Education Plan) (pdf)
- Sample Section 504 (pdf)
- Occupational Therapy recommendations (pdf)
- Daily School Symptoms Checklist (pdf)
- Technical Assistive Technologies (pdf)
- Academic Checklist for Strength and Needs when planning Educational goals (pdf)
- Sample Preschool Developmental Questionnaire (pdf)
- OHI What is Other Health Impaired? (pdf)
- Neurological Testing (an explanation) (pdf)
- Suggested Elementary School Accomodations for the child with Mito (pdf)
- Suggested Middle & High School Accomodations for the Student with Mito (pdf)
- Sample of Contents of an IFSP (Individualized Family Service Plan) (pdf)
- Sample 504 Accommodations (pdf)
- My Child needs an aide, how do I get one? (pdf)
- Debilitating Fatigue and School (letter) (pdf)
- Sample Letter for Schools and IEP Qualification using OHI (pdf)
- Sample Individual Health Care Plan (pdf)
- What is an Individualized Health Care Plan? (pdf)
- What is an extended school year? (pdf)
- What is a transitional IEP? (pdf)
- Suggested Protocol to share with a School Nurse (pdf)
- College Accommodation Planning (pdf)
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