Parent Information and Forms for Private Instructional Personnel (PIP) Requests
It is the desire of The School District of Lee County to work collaboratively with families and community providers to meet the unique needs of all students, specifically our students with disabilities in accordance with Florida Statute 1003.572.
All private instructional personnel desiring to observe, collaborate and/or provide services in The School District of Lee County for students with Individualized Education Plans must complete an application and submit for approval. All families and individuals desiring to complete an application for private instructional personnel to observe, provide services and collaborate with The School District of Lee County staff and students with Individualized Education Plans must complete a new application annually or if changes occur with private personnel or schools. Each application received will be good for the regular school year during the year in which it is completed if no changes occur during that year.
If you have any questions while completing these request forms, please contact the Exceptional Student Education Coordinator, Amy Bartlett at [email protected] or (239) 337-8295.
Updates for the 2023-2024 school year;
The Private Instructional Personnel process has changed for the 2023-2024 school year. These changes are to ensure that we are in compliance with the updated state statute per HB795. Please refer to the two attachments and review directions provided below;
Provider Forms (Packet 1) – This packet is to be completed by the agency with the providers.
When complete, please only submit pages 3-8/9 for review (See below for further details regarding the requirements)
Pag 3; Provides the company information and names/certifications of the individuals providing therapy in the school
Page 4-6; Please become familiar with the agreements within this document. There were a number of issues/concerns that resulted in the removal of providers on specific campuses because they were not aware of the expectations that were clearly outlined in the signed document. Continued violations of the same offense or similar offense will result in removal from all Lee County School Buildings/campuses.
- Page 6 clearly lists the additional required documents please review;
- Documentation of licensure (Supervision listed if necessary for practice)
- Copy of Vendor Badge with expiration date visible
- Signed communication agreement (Pg4-6)
- Signed Confidentiality statement (Pg7)
- Proof of Employment on Company Letter Head (NO EVerify or I9)
Page 7; Signed confidentiality statement
Pages 8/9; Contact information specific to the type of services (ABA Therapy, Pg 8 / Other Therapies, Pg 9)
*If your employees do not have a current vendor badge, please see the attached form below regarding vendor fingerprinting and/or visit this website
https://www.leeschools.net/cms/one.aspx?portalId=676305&pageId=1528899
Parent Information and Forms (Packet 2) – This packet is to be completed by the agency with the Parent/Guardian.
When complete, please only submit pages 3-7 for review, AND include pages 8 or 9 with providers contact information from Packet 1 (See below for further details regarding the requirements)
Pag 3; Provides the student demographic information and the company/provider information – PLEASE Remove any provider that is no longer working with the student and/or left the company from each case.
Page 4; Parent signatures acknowledgement of requirements of state statute
Pages 5-7; Parent signatures acknowledging their understanding of the agreements within this document (Communication Agreement).
Page 7 clearly lists the additional required documents please review;
- Completed Application (Pages 3-7)
- Approved Providers listed
- Signed Authorization of Release of Information Form (Lee County Public Schools or Agency form accepted)
- Private Behavior Plan or Plan of Care
- Private Providers Contact Information (Packet 1, page 8 or 9)
To submit a request, please make sure to include the student FULL NAME in the subject line or body of the email (For Packet 2 submissions) – Without this information it is near impossible to search for the submission. Please make sure to submit with students full names. Additionally, ALL submissions should be sent to [email protected] – We ask that you submit all files in a PDF format, if it must be password protected please use “LEE2023” as the password. Finally, it is helpful if you reduce the amount of attachments per email – meaning please submit each employee “file” as one document instead of multiple.
We will process requests as quickly as we can.