IEP Review Roster
Compliance Form 408
IEP Review Roster
Master Record of Special Education Accommodations & IEP Review Receipt
School Year: 2026 - 2027
Case Carrier: ________________
Official Acknowledgment (IDEA / Form 408 Compliance):
By signing below, teachers certify they have reviewed and will implement all student IEP accommodations, goals, behavior intervention plans (BIP), and assistive technology (AT) in accordance with federal and state regulations.
Teacher Name
Course / Subject
Class Period(s)
| Student Info | Key Plans & Services | Primary Accommodations | IEP Goals | Teacher Sign-Off |
|---|
| | | | |
| 1 | | | | |
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
2
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
3
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
4
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
5
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
6
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
7
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
8
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
9
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
10
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
File under Special Education Compliance Folder Page 1 of 3
Compliance Form 408
IEP Review Roster (Continued)
Teacher: _______________________
| Student Info | Key Plans & Services | Primary Accommodations | IEP Goals | Teacher Sign-Off |
|---|
| | | | |
| 11 | | | | |
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
12
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
13
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
14
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
15
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
16
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
17
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
18
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
19
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
20
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
File under Special Education Compliance Folder Page 2 of 3
Compliance Form 408
IEP Review Roster (Continued)
Teacher: _______________________
| Student Info | Key Plans & Services | Primary Accommodations | IEP Goals | Teacher Sign-Off |
|---|
| | | | |
| 21 | | | | |
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
22
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
23
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
24
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
|
25
ID: _________ Gr: ____
|
BIP
AT
Hearing
Vision
Beh. Consult
|
Extra Time
Oral Read
Pref. Seat
Reviewed All
|
Reading
Math
Writing
Behavior
Rel. Serv.
|
Signature Date: ____
|
Master Compliance Acknowledgment & Oath
I hereby certify that I have read the individual education programs (IEPs) for the students logged in this roster. I recognize my responsibility to strictly adhere to the accommodations, support goals, modifications, behavior intervention plans (BIP), and assistive technology requirements documented. I understand that the information is confidential under FERPA and shall only be shared with authorized personnel.
Teacher Signature
Date Submitted
Return signed copy to Case Carrier / Special Ed Department Page 3 of 3