Get Ssa-5666 2011-2025

The SSA-5666 is a crucial form for collecting administrative information regarding a child's educational evaluations and services. This guide provides you with step-by-step instructions to help you complete the form online accurately and efficiently.

Follow the steps to successfully complete the SSA-5666 form.

1. Click ‘Get Form’ button to obtain the form in an online format. This allows you to easily fill out the necessary information digitally.
2. In the first section, you will need to attach a label or type in the name of the claimant. Make sure to verify the spelling and accuracy of the name provided.
3. Next, enter the requesting office name and address. This ensures the completed form reaches the correct location for processing.
4. Address questions related to the child’s recent evaluations or testing. Indicate the kind of tests conducted and provide the corresponding dates.
5. Continue by detailing any referrals for assessments or services. Specify to whom the referrals were made and include the relevant dates.
6. Provide the current instructional levels in reading, math, and written language, including scales or ranks based on standardized assessments.
7. List any grades that have been repeated. Check the applicable grades from kindergarten through 12th grade.
8. Identify any educational disabilities the child may have. Select applicable categories and provide additional specifications as needed.
9. In the placement and related services section, check all that are relevant, such as therapies received or special education instruction.
10. Use the additional comments section to continue any previous answers and add more information that may assist in evaluating the child’s functioning.
11. Finally, ensure to provide your name and title and the date on the designated lines. If others contributed to filling out the form, include their information as well.
12. You can now save your changes, download, print, or share the completed form as needed.

Complete your SSA-5666 form online today for timely processing.