Shortened School Day Survey

About your student

We are asking you to complete the following survey because your child has not been allowed to attend full school days because of behavioral problems. Disability Rights Oregon will use this data to reduce the use of shortened school days by school districts as a way to remove students with difficult behaviors from school. If you are responding to this on behalf of more than one child, please complete a survey once for each child.

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* 1. Child's Age

5-8

9-11

12-18

19-21

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* 2. Child's Gender

Male

Female

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* 3. The child is a ward of the court or has a state guardian

Yes

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* 4. The child is in foster care

Yes

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* 5. Child's disability (please check all that apply)

Autism Spectrum Disorder

Communication Disorder

Deafblind

Developmental Delay

Emotional Disturbance

Hearing Impairment

Intellectual Disability

Specific Learning Disability

Traumatic Brain Injury

Visual Impairment

Other Health Impairment (please specify)

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* 6. Please select the Oregon school district that currently serves the child:

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* 7. The child has an IEP or 504 plan

Yes