504 Plan Template Accommodations Checklist Teacher Handout

About this resource

"Extended time" is a category. "Time and a half on classroom tests in every class, arranged by the teacher, in the room or the testing center" is an accommodation a substitute could do on day one.

This kit writes 504 plans the second way, as a fillable PDF. The limitation in observable terms, the accommodation that addresses it, the setting, the adult who does it, and a check that it happened. Type it once, Save As per student, and save the teacher handout once per teacher.

WHAT IS INCLUDED - 18 pages, fillable

Prepare

• Referral and Meeting Prep Worksheet - the concern, the impairment as the family and records describe it, and a table of what it limits at school, in observable terms, with evidence. The limitation column is the plan.
• Documentation and Data Summary - nine sources, from whom, dated, what each shows, and what is still missing.

THE MENU - five categories, 37 items, each with a line for what it looks like in this building

• Instruction (10), Assignments (8), Testing (7), Environment (6), Health and Behavior (6). Every item is tied back to a limitation on the prep page.

The Plan

• The 504 Plan - one page: the limitation, eight accommodation rows written as what the adult does, each matched to a limitation, a setting, a named adult and a start date.
• Teacher Implementation Handout - one per teacher, deliberately incomplete: no medical history, no eligibility discussion, only what that teacher has to do differently.
• Testing and Assessment Accommodations - used in class, classroom tests, district or state test permitted, confirmed by whom and when, and a box for what is NOT permitted so nobody promises it.

The People

• Student Input and Self-Advocacy - what is hard, what helps, what they do not want, and the sentence they will actually say to ask for it.
• Family Summary and Meeting Notes - the plain-language half that goes home, and the notes that stay.

Check And Review

• Implementation Check - every accommodation, every teacher, asked directly: is it happening, and what is the evidence.
• Annual Review - still needed, still used, still working; keep, revise or drop with the reason.

Plus the plan FILLED IN for an invented seventh grader, with a note on what is deliberately not on it, and a page of ten accommodations written "in a hurry" beside the same ten written so they get done.

What This Is, And What It Is Not

It is a fillable PDF. Open it in a PDF reader, click a line or a box, type, press Tab to move on, and Save As once per student. It works offline with no account or subscription. It is NOT a Google Slides deck, a Google Doc, or a PowerPoint file. Prefer paper? Print it blank.

It is not legal advice. It does not say who qualifies for a 504 plan, how the evaluation works, or what timelines apply; your district's 504 process decides that. Nothing in it diagnoses anything: the impairment is written as the family and the records describe it. Where the conversation turns to specially designed instruction, the pages say that is an IEP conversation. If your district has its own 504 form, these pages are the working paper behind it.

Who This Is For

504 coordinators, school counselors, case managers, and the general education teachers who end up writing the plan because the meeting is at 7:30 and it has to be doable by 8:15.