Level of support needed
Grade level: ______
Subject area: ______
Code / Levelof support / Description
T / Transitional / The amount of support (low, medium, high) is provided temporarily to assist a student in gaining independence
in new environments, activities and/or acquisition of new concepts.
L / Low / This support is always available but not needed on a regular basis by the student. The student would be able
to function in the environment without the support, just not as successfully.
M / Medium / This support is necessary on a regular basis in order for the student to be successful or to learn in the environment.
H / High / This support is absolutely necessary for the student to learn and must be provided consistently. The student could
not function in the environment without the support.
Student name / Disability / Gender
(M/F) / Behavior support / Academic support
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Student name / Disability / Gender (M/F) / Behavior support / Academic support
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Student name / Disability / Gender (M/F) / Behavior support / Academic support
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11/2004