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504 plan template

No federal 504 form exists. These four templates cover the paperwork a parent writes, from the evaluation request to the annual review.

Julian Moreira, Advocate

Last reviewed

Section 504 of the Rehabilitation Act is federal law and reads the same in every state. The paperwork does not. No federal 504 plan form or template exists, so the plan document, the referral form, the evaluation timeline, and the review cycle are all district practice. The four templates on this page are the parent's side of the file and no agency endorses them. Ask your district for its written Section 504 procedures and its own referral form before you send anything.

Quick answer

There is no federal 504 plan template. No form, no PDF, nothing the federal government publishes for a parent to fill in and file. Districts write their own, and the district writes the plan.

What a parent writes is the other half of the file. Four templates below cover that half. The request for an evaluation, the proposal you carry into the meeting, the email that confirms what was decided, and the letter that reopens the plan a year later. Copy one, change the bracketed parts, send it. Read what a 504 plan is first if the term is new. If you want to see a finished district document, the 504 plan examples page has five.

Why there is no 504 form to download

Nothing in 34 C.F.R. Part 104 sets a template, a page count, or a review date. Search the regulation for the phrase "504 plan" and you get zero hits. The Office for Civil Rights (OCR), which enforces Section 504 in schools, calls the plan document "not explicitly required by the Department's Section 504 regulations."

So the files circulating online as a 504 plan form are one of two things. Somebody's district form, scanned. Or somebody's idea of what a plan should say.

Your district will use its own either way, and the plan gets written by a group after an evaluation, which means a template you filled in at home and handed across the table creates nothing. What your paperwork does is narrower than that. It sets a date. It puts the request in the district's own file, and it leaves something a coordinator has to answer.

What the district's form already covers

The district's plan document carries the student identifiers, the impairment and the major life activity it limits, the evaluation information the group used, the accommodations, who provides each one, the start and review dates, the names of the people who decided, a distribution list, and a signature line. Those nine fields, and the two that districts skip, are laid out on 504 plan examples.

Do not rebuild that form. It is theirs. A parent-built version of it gets set aside, and you will have spent your prep time on formatting.

Bring these four documents instead. Each one does a job the district's form does not do.

Template 1. Written request for a 504 evaluation

When to use it. Before anything else. Send it the week you decide a condition is affecting your child at school, addressed to the principal and copied to the district's Section 504 coordinator. Any district with 15 or more employees has to designate one, under 34 C.F.R. § 104.7(a). Call the front office for the name if the website does not list it.

Written request for a Section 504 evaluation

To: [principal name], Principal, [school] Cc: [coordinator name], Section 504 Coordinator, [district] Subject: Request for a Section 504 evaluation, [child's name], grade [x] I am requesting an evaluation of my child, [child's name], date of birth [date], grade [x] at [school], under Section 504 of the Rehabilitation Act of 1973. Here is what I have seen. [Observation one, with dates.] [Observation two, with dates.] [Observation three, with dates.] I believe a disability is behind it, and that it substantially limits [major life activity, for example concentrating, reading, sleeping, eating, or the operation of a major bodily function]. I have attached [medical records, outside evaluations, report cards, attendance printouts, teacher emails]. Please also consider the school's own records for [child's name]. Please write back with four things. Who will conduct the evaluation. What the district's written Section 504 timeline is. What information the group will review. The date of the meeting where the group will decide. If the district decides not to evaluate, please put that decision in writing and send me the notice of procedural safeguards. [Parent name], [phone], [email], [date]

What to customize. The three observations do the work, so write what a teacher would recognize and put dates on them. "Missed 14 days since September, 9 of them for migraines" beats "struggles with attendance." Then list what you attached. The list survives even when the attachment goes missing.

One thing not to write. Do not quote a federal deadline. Section 504 sets none, and OCR says so outright. "Section 504 does not provide a specific amount of time for school districts to complete an evaluation." A parent who opens with "you have 60 days under federal law" gets corrected by the same person who is deciding the request, and that 60 days belongs to the Individuals with Disabilities Education Act (IDEA) at 34 C.F.R. § 300.301(c)(1). Ask for the district's own written timeline instead. If a number exists in local policy, that is the number you can hold them to.

Template 2. The accommodation proposal you bring to the meeting

When to use it. After the evaluation and before the meeting. Send it with your request for the draft plan, at least three school days out, and bring a printed copy for every person at the table.

One block per request. Each block answers four questions the group is going to ask anyway.

  • What in the evaluation supports it
  • What exactly you are asking for
  • Who does it
  • How anyone would know it happened

Accommodation proposal worksheet

504 accommodation proposal Student: [name], grade [x], [school], student ID [number] Meeting date: [date] Submitted by: [parent name], [phone], [email], sent [date] Request 1 What the evaluation shows: [the finding, the report it came from, and the date of that report] What I am asking for: [the thing, the amount, and the setting. For example. Time and a half on in-class tests and quizzes in every subject, taken in a separate quiet room away from the group.] Who does it: [the role, not the person. For example. Each classroom teacher, with the counselor booking the room.] Start date: [date] How we will know it happened: [the record that proves it. For example. The counselor logs each separate-setting test.] [Copy the block above for each request. Stop at five.] I would like each accommodation the group agrees to written into the plan with the amount, the setting, the start date, and the staff role responsible. If the group writes one differently, please read the district's wording out loud before we sign, so I know what my child's teachers will actually read.

What to customize. Everything in brackets, and the count. Five requests is the ceiling, because a parent who brings twenty gets a meeting about the list. Name a role rather than a person on the "who does it" line. Ms. Alvarez leaves in June and "sixth-period science teacher" does not.

One thing not to write. Do not put specially designed instruction on this sheet. A reading program, a resource period, a special education teacher reteaching content a different way, those come from IDEA, which defines specially designed instruction at 34 C.F.R. § 300.39 as adapting the content, methodology, or delivery of instruction. Some districts will write it onto a 504 plan to be helpful, and in the room it looks like a win. You then have the service without IDEA's evaluation, without annual goals, and without progress reporting, which leaves you nothing to point at the year it quietly stops.

Template 3. The confirmation email after the meeting

When to use it. Within 24 hours, while you still remember who said what.

The plan document records the decisions. It does not record the parts that decide whether those decisions happen. Which teacher had not read the evaluation, what the group said it would do about a substitute who ignores the plan, and who is sending the document out and by when. Your email is usually the only place any of that exists.

Confirmation email after a Section 504 meeting

Subject: Confirming today's Section 504 meeting, [child's name], [date] Thank you for meeting today. I am writing down what I understood so that anyone can correct me. The group found that [child's name] [is or is not] a student with a disability under Section 504, based on [the evaluation information the group named]. The group agreed to these accommodations. [List each one in the wording the group used, with the amount, the setting, the start date, and the staff role responsible.] The group did not agree to [request], and the reason given was [reason]. Open items. [Who is sending the plan to teachers, and by when.] [The date the group will look at the plan again.] [Anything left to check.] If any of this is wrong, please correct it in writing. Otherwise I will treat it as what we agreed. Please also send me the signed plan and the distribution list showing which staff received a copy. [Parent name], [date]

What to customize. Quote the wording the group settled on, exactly, including the wording you disliked. If you write it down wrong, the reply corrects you, and a correction in writing does the same job as being right.

One thing not to write. Do not add anything the group did not agree to. A confirmation email that grows a sixth accommodation stops being a record and becomes a proposal. What comes back is a denial you now have to argue about, and the district has a reason to treat the rest of the email as disputed too. Send the new request separately, in its own message, on a different day.

Template 4. The 504 meeting request letter, for a status check or an annual review

When to use it. Two situations, one letter. An accommodation is not happening, or the plan is a year old and nobody has looked at it.

There is no federal review cycle. 34 C.F.R. § 104.35(d) requires periodic reevaluation, and a reevaluation before any significant change in placement, and it sets no interval on either one. Many districts review a 504 plan once a year, which is local practice rather than federal law. So a plan written in third grade can follow a student into sixth grade with the same seat assignment on it. What reopens it is usually a parent asking.

504 meeting request letter, status check or annual review

To: [coordinator name], Section 504 Coordinator, [district] Cc: [principal name], Principal, [school] Subject: Section 504 plan review request, [child's name], grade [x] My child, [child's name], grade [x] at [school], has had a Section 504 plan since [date]. I am asking the group to meet and review it. [Use this paragraph if accommodations are being missed.] These accommodations are in the current plan and did not happen. [Accommodation, and the dates it was missed.] [Accommodation, and the dates it was missed.] [Use this paragraph if the plan is out of date.] [Child's name] has [changed schools, moved up a grade level, started or stopped a medication, received a new diagnosis, or had the condition change]. The current accommodations were written in [year], and [describe what no longer fits]. Please tell me the date of the review meeting, who will attend, and what information the group will look at. Please also send me the current plan and the distribution list, so I can see which staff have a copy. [Parent name], [phone], [email], [date]

What to customize. Dates and specifics. "Extended time was not offered on the November 14 unit test or the December 2 midterm" is a fact a coordinator can check in an afternoon. "It is not being followed" is an argument, and arguments get scheduled for later.

One thing not to write. Do not open with the complaint routes. "If this is not corrected I will file with the Office for Civil Rights" turns a scheduling email into a legal posture, and the person reading it is the coordinator whose job is scheduling the meeting. The routes are real and they keep. The district's grievance procedure sits at 34 C.F.R. § 104.7(b), the impartial hearing at § 104.36, and an OCR complaint has to be filed within 180 days of the discrimination. Use them when the meeting fails, rather than in place of asking for one.

Where an advocate fits

The narrow job is the wording. An advocate reads the evaluation against the draft plan, puts your requests into words the district recognizes, and sits next to you while the group works through them. Advocates are not attorneys. They cannot file a lawsuit or represent you at a due process hearing. Most advocates on our directory charge $75 to $150 per hour, and you can search by state to see who works near you.

What these templates cannot do

None of them binds a district. Send all four in perfect order and the group can still write something different, because the duty runs to an appropriate education under 34 C.F.R. § 104.33 rather than to the accommodation you named.

Five more limits.

  • A letter does not force an evaluation. OCR puts it this way. "Although a parent does not have an absolute right to a Section 504 evaluation upon request, a school must evaluate a student if the school has reason to believe the student is in need of special education or related services because of a disability."
  • Sending one creates no deadline. Federal law sets none for a Section 504 evaluation, and OCR judges delay against the IDEA timeline, a state requirement, or local district policy.
  • These are not your district's forms. If the district has a referral form of its own, fill it in and attach your letter to it. Refusing to use their form buys you an argument about the form.
  • Nothing here is legal advice. Section 504 reads the same in all 50 states, and the timelines, the templates, and the person who answers your email do not.
  • A template cannot make anyone read the plan. That gap is where most 504 plans fail, and no letter closes it on its own.

Send the request and keep the reply. Six months from now, the only thing that will settle when you asked is the timestamp on the email.

Sources

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