Important Steps, Inc.
SEIT MONTLY LOG – 2012/2013 School Year -- Page 1 of 2
Child’s Name:______IEP Weekly Mandate______X30(min) Location: Home ___School ___
SEIT’s Name: ______Title/Credentials: ______
FOR THE MONTH/YEARof :AUGUST2012
# of ½ Hour Sessions NOT provided / If Session Was NOT Conducted Use Absence Code(Circle Code Below) / Check Box if Makeup Session was ConductedIndicate Month for Makeup (e.g. 09/10)
Day / Date / Start Time / End Time / # of ½ Hour Sessions Provided / Due to Legal Excuse / Due to Illegal Excuse
Wed / 1 / am/pm / am/pm / E A H C P R /
Thurs / 2 / am/pm / am/pm / E A H C P R /
Fri / 3 / am/pm / am/pm / E A H C P R /
Sat / 4 / am/pm / am/pm / E A H C P R /
Sun / 5 / am/pm / am/pm / E A H C P R /
Mon / 6 / am/pm / am/pm / E A H C P R /
Tues / 7 / am/pm / am/pm / E A H C P R /
Wed / 8 / am/pm / am/pm / E A H C P R /
Thurs / 9 / am/pm / am/pm / E A H C P R /
Fri / 10 / am/pm / am/pm / E A H C P R /
Sat / 11 / am/pm / am/pm / E A H C P R /
Sun / 12 / am/pm / am/pm / E A H C P R /
Mon / 13 / am/pm / am/pm / E A H C P R /
Tues / 14 / am/pm / am/pm / E A H C P R /
Wed / 15 / am/pm / am/pm / E A H C P R /
Thurs / 16 / am/pm / am/pm / E A H C P R /
Fri / 17 / am/pm / am/pm / E A H C P R /
Sat / 18 / am/pm / am/pm / E A H C P R /
Sun / 19 / am/pm / am/pm / E A H C P R /
Mon / 20 / am/pm / am/pm / E A H C P R /
Tues / 21 / am/pm / am/pm / E A H C P R /
Wed / 22 / am/pm / am/pm / E A H C P R /
Thurs / 23 / am/pm / am/pm / E A H C P R /
Fri / 24 / am/pm / am/pm / E A H C P R /
Sat / 25 / am/pm / am/pm / E A H C P R /
Sun / 26 / am/pm / am/pm / E A H C P R /
Mon / 27 / am/pm / am/pm / E A H C P R /
Tues / 28 / am/pm / am/pm / E A H C P R /
Wed / 29 / am/pm / am/pm / E A H C P R /
Thurs / 30 / am/pm / am/pm / E A H C P R /
Fri / 31 / am/pm / am/pm / E A H C P R /
E=LegalA=Illegal H= Nat’l HolidayC=Important Steps’ ConferenceP= Provider Abs. R=Official Recess
“E”-Legally absent: Child’s illness and/or hospitalization; Death in family;Family member illness/emergency; Religious observance; Transportation issues; Severe weather; other approved by NYS Commissioner / “A”- Illegal absence – Absences for reasons other than above / “H”- Major National Holidays when school is closed (please refer to school’s calendar) / “C”-School or Important Steps, Inc. are closed for conference/staff development. / “P”-Provider absent“R” -Official school recess periods: Winter, Mid-Winter, Spring (must correlate with Important Steps, Inc. calendar)
SEIT’s Signature: ______Date: ______
SEIT Supervisor’s Name: ______Signature:______Date:______
FOR OFFICE USE ONLY
Total Authorized ½ Hour Sessions Provided (Monthly Mandate Times 5) - ______
Total Remaining ½ Hour Sessions (Monthly) - ______
****NOTE: SESSION NOTES(Originals) & Attendance Card (COPY) Must be Attached and match to this Monthly Log***
Important Steps, Inc.
SEIT MONTLY LOG – 2012/2013 School Year -- Page 2 of 2
Multidisciplinary Meeting- Monthly Contact Note
SEIT Case Coordination-July 2012
Student’s Name: ______NYC ID#: ______
Multidisciplinary Team Meeting (“MTM”) Conducted: No ___ Yes ___ Date:______
If “No” List Individual Contacts w/RS Providers:
List Namesof All Participants:
ST: ______Date: ______PT:______Date:______
G. E. Teacher:______Date:______OT: ______Date:______
CO: ______Date:______CSE/Other: ______Date:______
Type of Contact[ ]Phone[ ]In Person
Summary of Meeting (In narrative form, please describe who was contacted, what was discussed, any issues that have arisen, troubleshooting and problem solving.):
Required Follow-Up/Next Steps:Was the parent informed of the content of the MDT meeting? Yes or No
SEIT’s Name: ______SEIT’s Signature: ______