Education Case Management Checklist Template
Master education case management with our comprehensive checklist template. Ensure student success, compliance, and seamless processes - download now!
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Student Information & Referral
Initial data collection and referral process.
Student Full Name
Student ID Number
Date of Referral
Referring Party
Reason for Referral (Brief Description)
Grade Level
Supporting Documents (Optional)
Assessment & Planning
Comprehensive assessment of student needs and development of a personalized plan.
Presenting Concerns & Referral Reason
Areas of Need (Select all that apply)
Age
Date of Assessment
Primary Diagnosis/Suspected Diagnosis (if applicable)
Summary of Assessment Findings
Strength Identification
Intervention Implementation
Execution of planned interventions and supports.
Intervention Start Date
Intervention Methods Used
Details of Intervention Activities
Frequency of Interventions (e.g., sessions per week)
Next Intervention Date
Intervention Delivery Method
Supporting Documentation (e.g., therapy notes)
Progress Monitoring & Evaluation
Regular tracking of student progress and evaluation of intervention effectiveness.
Academic Performance Score (e.g., GPA, Standardized Test)
Behavioral Observations - Level of Concern
Summary of Progress Towards Goals
Date of Last Progress Monitoring Review
Areas Where Progress is Below Expectations
Attendance Rate (%)
Collaboration & Communication
Maintaining consistent communication and collaboration with relevant stakeholders.
Communication Method
Last Communication Date
Summary of Communication
Communication Recipient Role
Contact Person Name
Frequency of Communication (per week)
Documentation & Reporting
Accurate and thorough documentation of case activities and generation of required reports.
Date of Documentation
Summary of Case Activities
Hours of Service Provided
Supporting Documents (e.g., assessment reports)
Report Type
Staff Signature
Case Closure & Transition
Formal closure of the case and planning for student transition to other supports.
Case Closure Date
Summary of Case Progress & Outcomes
Reason for Case Closure
If 'Other' - Please specify reason for closure
Transition Plan Type
Details of Transition Plan (e.g., specific supports, referrals)
Transition Documents (e.g., referral letters, IEP updates)
Legal and Compliance
Ensuring adherence to relevant legal requirements and school policies.
FERPA Consent Form Received Date
504 Plan Compliance?
IEP Compliance?
Number of Documented IEP Meetings
Summary of Legal Consultation (if applicable)
Date of Last Legal Review
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