Temporary Accomodation Plan Form
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1
2CONFIDENTIAL
Louisiana Department of Education
LDOE 12/2014
TEMPORARY ACCOMMODATION PLAN (TAP)
________________________________________________
Local Educational Agency (LEA)
Student ________________________ ________________________ DOB ___________________ Grade ___________
Last
First
School _______________________________________ SBLC/504 Chairperson ________________________________
What date was the Temporary Accommodation Plan (TAP) developed? _______________________________________
What is the implementation date of the Temporary Accommodation Plan? _____________________________________
Was the student identified with a disability prior to this incident?
Yes
No
If yes, note the identified disability and any services received. Disability ______________________________________
Section 504 IAP ______________________________
IEP _______________________________________
What is the temporary illness, injury, or disabling condition? ________________________________________________
Is the expected duration of this condition 6 months or less? ?
Yes
No
List documentation to support the condition and need for these accommodations. ________________________________
What is the expected duration of this temporary disability? __________________________________________________
Indicate standardized assessments expected to be taken while student is receiving these accommodations. _____________
List all required standardized assessment accommodations and justification. ____________________________________
__________________________________________________________________________________________________
Note: The TAP is not intended for use as an interim or temporary Section 504 plan.
Signatures of SBLC/SAT Members participating in development of Temporary Accommodation Plan
Parents ____________________________________________________
Date ____________________________
Student____________________________________________________
Date ____________________________
Teacher ___________________________________________________
Date ____________________________
Principal/Designee ___________________________________________
Date ____________________________
504/SBLC Member __________________________________________
Date ____________________________
504/SBLC/SAT Chairperson___________________________________
Date ____________________________
Signature is required if student needs accommodations for standardized assessment.
School Test Coordinator _________________________________________________ Date ______________________
District Test Coordinator _________________________________________________ Date _____________________
Standardized Testing Accommodations (As aligned with above accommodations and disability)
Check assessments to be taken within one year: (1) Grades 3-8 State Assessments (2) EOC (3) ELDA (4)
EXPLORE (5) PLAN (6) ACT (7) Other_____________
(00) None (Student does not need standardized testing accommodations or has completed all required testing)
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