Inputs the user provides
- [[Student Full Name]]
- [[Grade Level or Age]]
- [[School or Educational Setting]]
- [[Primary Disability or Impairment Description]]
- [[Major Life Activities Substantially Limited]]
- [[Specific Impacts Observed in Setting]]
- [[Current Evaluation Data or Medical Information]]
- [[504 Coordinator or Case Manager Name]]
- [[Review Date or Meeting Date]]
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Deliverable
504 Accommodation Plan for [[Student Full Name]]
School / District: [[School or Educational Setting]]
Grade: [[Grade Level or Age]]
Plan Effective Date: [[Plan Effective Date]]
Review / Re-evaluation Date: [[Review Date or Meeting Date]]
504 Coordinator: [[504 Coordinator or Case Manager Name]]
Eligibility Determination
[[Student Full Name]] has been determined eligible for a Section 504 plan under the Rehabilitation Act of 1973. The student has a physical or mental impairment that substantially limits one or more major life activities.
Identified Impairment: [[Primary Disability or Impairment Description]]
Major Life Activity Substantially Limited: [[Major Life Activities Substantially Limited]] (e.g., learning, concentrating, reading, writing, communicating, walking, seeing, hearing, breathing, self-care)
How the Impairment Impacts Access in the Specific Setting
In the [[School or Educational Setting]] classroom and school environment, the impairment substantially limits [[Student Full Name]]'s ability to:
1. Access grade-level instructional content at the same pace and depth as peers without accommodations.
2. Sustain attention and complete multi-step tasks without targeted supports.
3. Demonstrate learning through standard written or timed assessments.
4. Participate fully in classroom discussions, group work, or physical activities without barriers.
5. Maintain consistent attendance or energy levels throughout the school day due to health or fatigue factors.
These impacts are documented through [[Current Evaluation Data or Medical Information]] and teacher observations.
Concrete Accommodations
The following accommodations are provided to ensure equal access. Accommodations modify how the student learns or demonstrates learning; they do not change the content standards or expectations.
Accommodations are selected and tailored based on the student's documented needs and the demands of the specific educational setting. The team prioritizes the least intrusive effective supports.
| Category | Accommodation | Implementation Details | Responsible Staff | Frequency / Duration |
|---|
| Presentation | Extended time on assignments and assessments | 50% additional time; breaks as needed; chunked instructions provided in writing and verbally | Classroom teacher, testing coordinator | All tests, quizzes, and major assignments |
| Presentation | Preferential seating | Seat near front of room, away from distractions, close to teacher or instructional materials | Classroom teacher | Daily instruction |
| Presentation | Use of FM system or assistive listening device | Teacher wears microphone; student uses receiver; checked daily by staff | Classroom teacher, audiologist or tech support if applicable | All verbal instruction periods |
| Response | Access to computer or word processor for written work | Spell-check and grammar supports enabled unless testing conditions prohibit | Classroom teacher, tech dept | Writing tasks, essays, note-taking |
| Response | Scribe or speech-to-text for extended written responses | Student dictates; scribe records verbatim or student uses approved software | Teacher or designated aide | When writing fatigue or fine motor limits present |
| Timing / Scheduling | Scheduled breaks during instruction and assessment | 5-10 minute movement or sensory break every 45-60 minutes; timer used | Classroom teacher | As needed, minimum once per core subject block |
| Setting | Reduced-distraction testing environment | Small group or separate quiet room with minimal visual/auditory stimuli | Testing coordinator | Standardized and classroom assessments |
| Health / Physical | Individualized health plan integration | Access to water, snacks, medication, or rest area per health plan; nurse consult available | School nurse, classroom teacher | As documented in health plan |
| Organization | Use of visual schedule, checklist, and graphic organizers | Daily checklist provided; color-coded folders; advance notice of schedule changes | Classroom teacher, case manager | Daily |
| Behavioral / Attention | Chunked directions with visual supports and repetition | Directions repeated, written, and modeled; student repeats back key steps | Classroom teacher | All multi-step tasks |
| Assessment | Read-aloud or text-to-speech on non-reading assessments | Human reader or approved software for math/science/social studies | Teacher or proctor | Non-reading content assessments |
| Assignment | Reduced length or focus on key elements for practice work | Focus on mastery of essential standards; reduced volume when appropriate without lowering rigor | Classroom teacher | Homework and classwork |
Additional Accommodation Details and Examples
1. For extended time: The student receives the full standard time plus 50 percent. Teachers note the adjusted due date on the assignment itself and in the gradebook. During timed classroom activities the student is informed privately of the end time and offered a quiet signal when half the extra time remains.
2. For preferential seating and reduced distraction: The seat is positioned so the student has clear line of sight to the board and teacher while minimizing sight lines to high-traffic areas or windows. A second "reset" seat may be designated for use during independent work if overstimulation occurs.
3. For chunked instructions and visual supports: Every multi-step direction is broken into numbered steps on a printed card or digital slide. The student may request a verbal re-read of one step at a time. Graphic organizers are provided for writing, note-taking, and problem-solving tasks and collected as part of the student's work sample portfolio.
4. For scheduled breaks: The student may use a pre-arranged nonverbal signal (e.g., colored card on desk) to request a break. Breaks are logged by the teacher on a simple tally sheet for data review. Break activities are limited to movement, water, or brief sensory regulation and do not become social time.
5. For technology access: The student is trained on any approved assistive technology at the beginning of each semester. A backup plan (paper version or alternate device) is identified in case of tech failure during high-stakes assessments.
6. For health-related supports: The 504 coordinator ensures the classroom teacher receives a summary of relevant health plan elements without violating privacy. The student has designated safe adult contacts for immediate needs.
Sample Weekly Implementation Checklist for Teachers
1. Review the student's 504 plan before the first class of the week.
1. Prepare any pre-printed materials, graphic organizers, or extended-time labels needed for the week.
1. Confirm technology or devices are charged and accessible.
1. Note any scheduled assessments and arrange reduced-distraction space or reader in advance.
1. Record one brief anecdotal note on accommodation effectiveness by Friday.
1. Communicate any concerns or data to the 504 coordinator via the shared log.
Progress Monitoring and Data Collection
The effectiveness of accommodations is monitored through:
- Weekly teacher checklist completion (see above)
- Bi-weekly review of work samples showing use of supports
- Student self-report (age-appropriate questionnaire or conference) once per month
- Parent feedback at least once per quarter
- Grade and assignment completion data compared to baseline
If data indicate an accommodation is not effective or is no longer needed, the 504 team reconvenes within 10 school days to consider adjustments.
Training and Communication Plan
- All teachers and support staff who work directly with [[Student Full Name]] receive a copy of the plan within 5 school days of its approval.
- The 504 coordinator conducts a 15-minute overview meeting or provides a recorded briefing for staff new to the student.
- A one-page "at-a-glance" summary (without sensitive medical details) is shared with substitute teachers via the sub folder.
- The student receives an age-appropriate explanation of key accommodations and how to request them.
Transition and Change of Setting Notes
When the student moves to a new grade, teacher, or school:
1. The current 504 coordinator forwards the full plan and recent monitoring data at least 10 school days before the transition.
2. A transition meeting is scheduled if the new setting presents substantially different demands (e.g., departmentalized middle school, new school building).
3. The receiving team reviews and may propose amendments within the first 30 days of the new placement.
Responsible Staff
- 504 Coordinator / Case Manager: [[504 Coordinator or Case Manager Name]] — oversees plan implementation, collects data, schedules reviews, serves as primary contact for parents.
- Classroom Teacher(s): Deliver daily instruction with accommodations; provide progress data; communicate concerns promptly.
- Specialist Staff (if applicable): School psychologist, counselor, nurse, OT/PT, speech-language pathologist — provide consultation, specific supports, or related services as noted.
- Paraprofessional / Aide (if assigned): Support implementation of specific accommodations under teacher direction.
- Parent/Guardian: Partner in implementation; provide relevant medical updates; participate in review meetings.
Evaluation Basis
Eligibility and accommodations are based on:
- [[Current Evaluation Data or Medical Information]] (medical, psychological, or educational evaluations)
- Teacher and parent input
- Review of academic performance, attendance, and behavioral data
- Observation of the student in the educational setting
The team determined that the impairment substantially limits major life activity(ies) compared to the average student in the general population and that accommodations are necessary for equal access.
Distinction from IEP / Specialized Instruction
This 504 plan provides accommodations only. It does not provide specially designed instruction, modified curriculum, or goals as would be found in an Individualized Education Program (IEP) under IDEA. The student is expected to meet the same grade-level standards as peers, with changes only to the manner or conditions under which learning and demonstration occur.
If the student's needs change such that specialized instruction is required, the team will refer for a full special education evaluation.
Review Cadence and Monitoring
- Formal review of this plan will occur at least annually or upon parent or staff request.
- Progress monitoring data on accommodation effectiveness will be collected every 4-6 weeks by the classroom teacher and shared with the 504 coordinator.
- A re-evaluation to determine continued eligibility will be conducted at least every three years or when significant changes in the student's condition or educational program occur.
- Next scheduled review meeting: [[Review Date or Meeting Date]]
Parent and Student Rights Notice
Parents and the student (when age-appropriate) have the right to:
- Receive notice of meetings and decisions
- Participate in meetings
- Review all relevant records
- Request an impartial hearing if they disagree with identification, evaluation, or placement decisions
- File a complaint with the Office for Civil Rights (OCR)
A copy of parent rights under Section 504 will be provided at the meeting and upon request.
Assumptions and Notes
- All specific times, devices, or personnel names not provided by user input have been filled with education-standard defaults and are marked for customization.
- This plan should be implemented immediately upon signature and communicated to all staff who work with the student.
- The student, when appropriate, should be involved in understanding and self-advocating for the accommodations.
Signatures
504 Coordinator: ______________________________ Date: _______
Parent/Guardian: ______________________________ Date: _______
Classroom Teacher: ______________________________ Date: _______
Student (if appropriate): ______________________________ Date: _______
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This 504 Plan is a living document. It must be reviewed and adjusted as the student's needs evolve. All staff responsible for implementation have received or will receive a copy of the plan and training on their specific responsibilities.
Template — not legal advice. Verify current Section 504 requirements, district policies, and state procedures. Consult your district 504 coordinator or legal counsel for jurisdiction-specific language and forms.