Important Steps



Important Steps, Inc. SEIT MONTLY LOG – 2012/2013 School Year -- Page 1 of 2Child’s Name:_____________________ IEP Weekly Mandate______ X 30(min) Location: Home ___School ___SEIT’s Name: _____________________________ Title/Credentials: _____________________________FOR THE MONTH/YEAR of : JULY 2012# of ? Hour Sessions NOT providedIf Session Was NOT Conducted Use Absence Code (Circle Code Below)Check Box if Makeup Session was ConductedIndicate Month for Makeup (e.g. 09/10)DayDateStart TimeEnd Time# of ? Hour Sessions ProvidedDue to Legal ExcuseDue to Illegal ExcuseSun1am/pmam/pmE A H C P RMon2am/pmam/pmE A H C P RTues3am/pmam/pmE A H C P RWed4am/pmam/pmE A H C P RThurs5am/pmam/pmE A H C P RFri6am/pmam/pmE A H C P RSat7am/pmam/pmE A H C P RSun8am/pmam/pmE A H C P RMon9am/pmam/pmE A H C P RTues10am/pmam/pmE A H C P RWed11am/pmam/pmE A H C P RThurs12am/pmam/pmE A H C P RFri13am/pmam/pmE A H C P RSat14am/pmam/pmE A H C P RSun15am/pmam/pmE A H C P RMon16am/pmam/pmE A H C P RTues17am/pmam/pmE A H C P RWed18am/pmam/pmE A H C P RThurs19am/pmam/pmE A H C P RFri20am/pmam/pmE A H C P RSat21am/pmam/pmE A H C P RSun22am/pmam/pmE A H C P RMon23am/pmam/pmE A H C P RTues24am/pmam/pmE A H C P RWed25am/pmam/pmE A H C P RThurs26am/pmam/pmE A H C P RFri27am/pmam/pmE A H C P RSat28am/pmam/pmE A H C P RSun29am/pmam/pmE A H C P RMon30am/pmam/pmE A H C P RTues31am/pmam/pmE A H C P RE=Legal A=Illegal H= Nat’l Holiday C=Important Steps’ Conference P= Provider Abs. R=Official Recess“E”- Legally absent: Child’s illness and/or hospitalization; Death in family; Family member illness/emergency; Religious observance; Transportation issues; Severe weather; other approved by NYS Commissioner / “A”- Illegal absence – Absences for reasons other than above / “H”- Major National Holidays when school is closed (please refer to school’s calendar) / “C”-School or Important Steps, Inc. are closed for conference/staff development. / “P”-Provider absent “R” -Official school recess periods: Winter, Mid-Winter, Spring (must correlate with Important Steps, Inc. calendar)SEIT’s Signature: ______________________________________________ Date: ___________________SEIT Supervisor’s Name: ___________________________Signature:___________________________ Date:___________FOR OFFICE USE ONLYTotal Authorized ? Hour Sessions Provided (Monthly Mandate Times 5) - _________________________Total Remaining ? Hour Sessions (Monthly) - __________________________****NOTE: SESSION NOTES(Originals) & Attendance Card (COPY) Must be Attached and match to this Monthly Log***Important Steps, Inc.SEIT MONTLY LOG – 2012/2013 School Year -- Page 2 of 2Multidisciplinary Meeting- Monthly Contact NoteSEIT Case Coordination-July 2012Student’s Name: ______________________________NYC ID#: _____________________Multidisciplinary Team Meeting (“MTM”) Conducted: No ___ Yes ___ Date:________ If “No” List Individual Contacts w/RS Providers: List Names of All Participants: ST: ______________________ Date: _______PT: _________________________Date:_________G. E. Teacher:_______________ Date:_______OT: _________________________Date:_________ CO: ________________________Date:_______ CSE/Other: ___________________Date:_________Type of Contact [ ]Phone [ ]In PersonSummary of Meeting (In narrative form, please describe who was contacted, what was discussed, any issues that have arisen, troubleshooting and problem solving.):Required Follow-Up/Next Steps:Was the parent informed of the content of the MDT meeting? Yes or NoSEIT’s Name: ____________________ SEIT’s Signature: ___________________________________________ ................
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