Referral and Intake Process for Special Education

Nine school districts located in Dakota County and southern Hennepin County identify and refer students with certain disabilities to Intermediate School District 917 to provide special education services.  Services are offered in the least restrictive environment appropriate to each student.   

Here are the steps for students referred for special education services:

  1. A member district's special education director completes the referral request form and submits it to Intermediate District 917 at [email protected]
  2. Upon receiving the request, an administrator from Intermediate District 917 will contact the referring school district to discuss the student's programming needs.
  3. The referring school district schedules an IEP meeting that includes a representative from the referring school district, Intermediate District 917, and the student's parent/guardian.  During the meeting, the team discusses the student's needs and completes any additional forms.
  4. The student's IEP is updated by the referring school district and the student is enrolled in an Intermediate District 917 program. 

Referring school districts often assist parents in completing the referral process.  The forms below are completed as part of the referral process.

For learners with specialized health care needs (such as seizure disorders, asthma, diabetes, and allergies), see the ISD 917 Health Services Information page regarding Health Records and Medication and Specialized Health Care Procedure.

In order to attend school, students also must show that they are in compliance with Minnesota School Immunization Requirements. See the ISD 917 Health Services page regarding Immunization for more details.

Districts completing a referral for Purchase of Services need to complete an ISD 917 Referral for Special Education Services Form only.

For requests for physical therapy services, member districts also must complete an ISD 917 Physical Therapy Physician Referral Form.

ISD 917 Centralized Intake Procedure
ISD 917 2021-2022 Referral Form

ISD 917 Referral for Service (for 917 internal use)
ISD 917 Supplemental Transition Plan (for 917 internal use)  
ISD 917 Intake Form (for ISD 917 internal use only)  
ISD 917 Consent to Release Form
Ethnicity/Race Form  
MDE Home Language Questionnaire  
ISD 917 Parent/Guardian-Student Handbook Parent Sign-off Form   
ISD 917 Physical Therapy Physician Referral Form
ISD 917 Use of Restrictive Procedures Notice  
ISD 917 IEP Billing Consent Letter to Parents
Minnesota Health Care Programs Brochure for IEP Billing  
Minnesota Health Care Programs Brochure-Spanish Version 

ISD 917 Student Emergency Contact Form (Rev. 1-20-16)

ISD 917 Authorization and Request for Administration of Medications
ISD 917 Annual Health Information Form
ISD 917 MA Consent Form

ISD 917 MA Consent Form (Spanish)