Kentucky Department of Education

 

Forms

Last Updated on Thursday, August 28, 2008 at 3:02 PM

The Division of Assessment Support has created a number of forms that can be downloaded for use by schools and districts in implementing the Commonwealth Accountability Testing System (CATS). The forms are included on this page for download in Microsoft Word, Adobe Acrobat .pdf, and .rtf files for generic word processors.

These forms may also be found on the forms page corresponding to the assessment being given.

2008-2009 CATS MEDICAL EXEMPTION FORM to request that student be granted a medical exemption from the statewide and accountability program for students in the regular assessment program (Note: a student's handicapping condition, if any, cannot be the basis for a medical exemption)

HIPPA Form

2008-09 Medical Exemption Form 2008 HIPPA Form

2008-2009 MEDICAL EMERGENCY FORM to be used for medical emergencies that require accommodations during testing that are not a part of an IEP, 504 Plan or PSP.

2008-09 Medical  Emergency Form
2008-2009 Other Exemption Form 2008-09 Other Exemption Form

Nondisclosure Agreement sets conditions for access to secure testing materials

Non-Disclosure Form Non-Disclosure form
Notification Form to inform authorities of alerts papers and their contents Notification of Authorities Form Notification of Authorities Form

2008 Notary Statement Form for collecting allegation incident information

Spring 2008 BAC Certificatin of Proper Test Administration Instructions

2008 Notarized Statement Form 2008 BACCPA Form Instr
2008 ACT Non-Participation Form 2008 ACT NonParticipation Form
For more information contact:

Assessment Information
500 Mero Street, 18th Floor CPT
Frankfort, KY 40601
Phone: (502) 564-4394
Fax: (502) 564-7749
dacinfor@education.ky.gov