Sample 504 Plan and IEP

for a Second-Grade Student with CFS

ANYTOWN ELEMENTARY SCHOOL

SECTION 504 STUDENT ACCOMMODATION PLAN

1. Describe the nature of the concern:

   “Student’s Name” is often unable to attend school full-time due to Chronic Fatigue Syndrome. He/she suffers fromsevere abdominal pain, headaches, sore throats, joint and muscle pain and reduced stamina

   
   
   
2. Describe the basis for the determination of handicap (if any):

   See attached letter from Doctor (Name)

   
   
   
3. Describe how the handicap affects a major life activity:

   Interferes with regular daily school attendance and impacts her ability to concentrate

   
   
   
4. Describe the reasonable accommodations that are necessary:
   
   
   1. Home tutoring: 5 hours/week
      
   2. Health Exempt PE
      
   3. Use of word processor
      
   4. Tutor will be provided with copies of the Teachers Manuals and curriculum guides and basic summaries of skills being taught
      
   5. Contact will be maintained between the tutor and teachers every 2-4 weeks to discuss progress at home and to share activities occurring at school
      
   6. “Student’s Name” will be included in any class activities and have the opportunity to participate in all school activities

Review/Assessment Date: As necessary

Attachments: Information regarding Section 504 of the Rehabilitation Act of 1973

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