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1342.12 Companion
July 12, 2017
Page 121
Manifestation Determination Review Discussion Guide
GENERAL INFORMATION
Student:
Date of Birth:
School:
Current Educational Setting(s):
Date of this Manifestation Determination Meeting:
Date of Alleged Behavior:
Alleged Behavior Resulting in this Analysis:
If functional behavioral assessment of this behavior has occurred, findings:
DATA REVIEW
Disability of student with associated conditions, if any:
Any behavioral features associated with this disability student has shown in the past:
Discipline history review: