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SECTION 504 – QUARTERLY MONITORING REPORT

Student: Alexis M. Teacher: Katy Clark (parapro)


Building: West Middle School Grade: 8

To monitor the effectiveness of Section 504 plans, it is important to obtain information regarding
classroom performance each quarter. This information will be filed in the Counselor’s Office and 504
Coordinator’s Office, and may be shared with the student and his/her parents. Please review the
student’s attached Section 504 plan, fill out this form online, print it off and sign it, and put it in
Amy Gray’s mailbox by Monday, February 9.

All of the accommodations specified in the student’s 504 Plan are being implemented in my classroom.
Yes No ~ If no, explain what is not being implemented and the reason(s) why:      

The current 504 Plan appears to be appropriate in meeting the student’s needs.
Yes No ~ If no, what changes do you recommend?

Please list any additional comments or concerns you have regarding this student: Alexis will ask for
help on specific areas she feels she needs support in only after I initiate support. My support is
directed by what she feels she needs help on (mostly homework help and test prep).

Date: _____________________
Teacher Signature

Sect504QuartReportform10/02/amk

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