Special Education Dispute Resolution

Dispute Resolution Online Facilitated IEP Request Form

Online State FIEP Request Web Form

IEP facilitation is a student-focused process in which a trained facilitator assists the IEP team in developing an IEP that provides a free appropriate public education (FAPE) to the student, as required under the Individuals with Disabilities Education Act (IDEA) 2004, and its implementing regulations.

We are requesting assistance in facilitating an IEP meeting and understand and agree to the following:

ADE/ESS/DR will provide a neutral State-coordinated facilitator at no cost to the participants.
The goal of the facilitated IEP meeting is to develop an IEP that provides a free appropriate public education (FAPE) to the student.
Using a facilitator is voluntary and cannot be used to delay or deny the parent’s rights to request mediation or file a due process complaint to request a hearing.
The facilitation will only take place if the required IEP team members are present or excused appropriately.
The facilitator is not a member of the IEP team, cannot provide legal advice to any participant, and does not represent the parent, student, school, district/charter school, or ADE/ESS/DR.
The facilitator is not a necessary participant in any subsequent proceedings relating to the facilitated IEP meeting and will not be called upon as a witness or consultant in any other administrative, judicial, or educational process, and no records, notes, or other work product of the facilitator shall be called for or subpoenaed in the future by any party or participant.
The public education agency (PEA) remains responsible for the education of the student and thus must make decisions when consensus is not possible. The PEA will provide prior written notice documenting its proposals and refusals to initiate or change the student’s identification, evaluation, placement, or FAPE.

The Arizona Department of Education / Exceptional Student Services / Dispute Resolution Unit is ONLY authorized to address issues regarding special education. Examples of issues that Dispute Resolution cannot address include allegations of abuse, neglect, discrimination, retaliation, harassment, civil rights violations, employment matters, Section 504 plans, school policy matters, or anything not specifically related to special education.

Please complete the following:

Requestor

Parent/Guardian

Charter/District

Other

Parent/Guardian Information

*Include all parents/guardians with educational rights that are likely to attend the IEP meeting.

Parent/Guardian

Selected?	First Name	Last Name	Phone Number	Email Address
Is Selected?	First Name	Last Name	Phone Number	Email Address

Student(s)

Selected?	First Name	Last Name	Date of Birth	Grade
Is Selected?	First Name	Last Name	Date of Birth	Grade

Address

Street Address

Address Line 2

City

State

Zip Code

Email Address

Charter/District Information

Charter/District

Please select a District or Charter School from the list below.

School Name

School Representative

Superintendent/Director

SPED Director

Other

First Name
Last Name

Address

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Fax Number

Email Address

What is the annual IEP review deadline date?

Guiding Questions

What are the priority topics you would like to address during the State-Coordinated FIEP process?

How might a facilitator change the team dynamic?

How did you hear about the FIEP program?

ADE Website

Raising Special Kids Referral

Conference Session / Community Presentation

School Teacher / Staff

Print Material

ADE Staff / Phone call

Other

Signature of Person Signing the FIEP Request

If you are a parent/guardian/adult student requesting a facilitator, your signature below authorizes the District or Charter School and its employees, agents, and contractors to disclose information to the State-Coordinated facilitator regarding your or your student’s identity, needs, and issues surrounding disagreements about educational programming. I understand that this information will be kept confidential.
Please hover your mouse over the field and sign your name using the virtual pen.

Signature*

Note: Click on the symbol above to erase the signature.

Questions concerning this form, or the Facilitation process may be addressed by contacting:

Arizona Department of Education
Attn: Director of Dispute Resolution
1535 West Jefferson, Bin # 62
Phoenix, Arizona 85007
Phone: (602) 542-3084 Fax: (602) 364-0641
Email: FIEPInbox@azed.gov

If you do NOT submit from this website, please send a copy of the FIEP request to the above address or fax number.

Additionally: If you have submitted your FIEP request outside of regular business hours it will be considered received by Dispute Resolution on the next business day.