Information
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School Name
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Site Visit Date
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Prepared by
Student File Checklist
Student Files
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Student File Checklist
Student File
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Sign-In Sheet Included?
Biographical Information
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Student Initials
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Student ID Number
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Grade Level
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Birth Certificate with Proper Name/Spelling
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Explanation
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Proof of Residency
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Explanation
Health Information
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Signed Emergency Medical Release
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Explanation
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Immunization Chart
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Immunizations Current?
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Explanation
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Explanation
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Vision Screening
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Vision Current? (K, 1, 3, 5, 7, 9, 11 and new students)
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Explanation
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Explanation
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Hearing Screening
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Hearing Current? (K, 1, 3, 5, 9, 11 and new students)
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Explanation
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Explanation
Academic Information
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Did student transfer from a different school?
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Records Release
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Explanation
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Transcript from Previous School
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Number of Release Requests Documented
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Date of Most Recent Request
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Most Recent School Grade Report
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Explanation
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State Test Results
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Explanation
Withdrawn Student Information
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Student Withdrawn files
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Student Initials
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Student ID Number
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Grade Level
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Student Withdraw Documentation
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Is there a complete copy of the withdrawn student's file on site
Overall Assessment
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General Comments or Concerns
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Student File Follow-up Needed?