PRS has responsibilities to review and act upon certain applications, requests for waivers, and notifications required by Board of Education Regulations. The information and mandated forms below should be used in responding to these requirements.
Notification of Intent to Seek Approval for Individual Student Program and Request for Pricing Authorization (Now Available to Submit Online!)
Physician's Affirmation of Need for Temporary Home or Hospital Education for Medically Necessary Reasons
Physician's Affirmation of Medical Reasons That Student is Likely to Remain at Home, in a Hospital, or in a Pediatric Nursing Home for More than 60 School Days
Massachusetts Law Prohibiting the Practice of Hazing
Approval Procedures for Initial Applications — Massachusetts Public Day School Programs
Revised Procedures for Special Education Public Day School Programs RE: Reapproval
Form 1 — Notification of Substantial Changes in a Public Day Program
Form 2 — Incident Report
Form 3 — Notification of Intent to Apply for Approval of a Public Day School or Program
Cover Letter: Request for Waiver Cover Sheet
Form A: Age Span Waiver 48-71 Months
Form B: Age Span Waiver 72 Months
Form C: Request for Waiver from Special Education Regulations: Alternative Compliance 603 CMR 28.03(5)
Form C1: Request for Waiver from Special Education Regulations: Special Education Parent Advisory Councils 603 CMR 28.03(5)
Special Education Class Size Notification
The restraint injury reporting materials are no longer available on this page.
The Restraint Data application in the Security Portal has been enhanced to include notification of injury. By completing and submitting a restraint record in this online application, you no longer need to complete and submit the separate "Student/Staff Restraint Injury Report" on paper whenever such notification to the Department is required.
Please select the hyperlink above to access the Department's Security Portal Restraint Data Admin Application to submit a restraint.
Restraint Form Sample
Restraint Form—Floor Prone Sample
Last Updated: October 1, 2021
Massachusetts Department of Elementary and Secondary Education
75 Pleasant Street, Malden, MA 02148-4906
Voice: (781) 338-3000
TTY: (800) 439-2370
Disclaimer: A reference in this website to any specific commercial products, processes, or services, or the use of any trade, firm, or corporation name is for the information and convenience of the public and does not constitute endorsement or recommendation by the Massachusetts Department of Elementary and Secondary Education.