Are you a Massachusetts resident looking to make changes to an existing hearing request or file an initial hearing request? If so, it’s important for you to be aware of the required paperwork and process. In this blog post, we’ll discuss how to complete the Massachusetts Hearing Request Form which is currently available on the official website of the Massachusetts Office of Environmental Affairs (MOEA). We'll go over all of the information that needs to be accurately filled out in order for your request to be valid and accepted by MOEA. Afterwards, we will list any additional documents that may also need to accompany your form submission. Read this guide carefully so that you are familiar with what is needed before submitting your application!
| Question | Answer |
|---|---|
| Form Name | Massachusetts Hearing Request Form |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min |
| Other names | massachusetts motion request for habe, fair hearing request form ma, bsea request get, ma hearing request form |
T H E CO MMO NW E AL T H O F MAS S ACH US E T T S
D I V I S I O N O F A D M I N I S T R A T I V E L B U R E A U O F S P E C I A L E D U C A T I O N
1C O N G R E S S S T R E E T , 1 1 T H
B O S T O N , M A 0 2 1 1 4
A W A P P E A L S A P P E A L S
F L O O R
TEL:
FAX:
http://www.mass.gov/dala/bsea
Hearing Request Form
COMPLETE ALL ITEMS ON THIS FORM.
Description of the Appeals Hearing process: A Special Education Appeals Hearing is conducted in accordance with federal and state statutes as well as the BSEA Hearing Rules. The Hearing Officer may conduct a
explanation of the Appeals Hearing process as well as a copy of the BSEA Hearing Rules may be found at the BSEA’s website: http://www.mass.gov/dala/bsea
THIS FORM MAY BE USED TO FILE A HEARING REQUEST FOR THE FIRST TIME OR TO AMEND A HEARING REQUEST THAT HAS BEEN PREVIOUSLY FILED.
Please indicate whether this is an Initial Hearing Request or an Amended Hearing Request.
Please check one: Initial Hearing Request:
Amended Hearing Request:
I. Student Information:
1.Student’s Name:
2.Student’s Address:
3.Student’s School District:
4.School Student Attends:
II. Person Requesting Hearing:
1.Name of Person Requesting Hearing:
2.Please check one:
Parent |
Attorney for school |
Student (if 18 or older) |
Attorney for parent/student |
School District |
Advocate for parent/student |
Educational Surrogate Parent*
Guardian*
Person appointed by court to make educational decisions*
Individual with whom the student lives and who is acting in place of parent
|
|
|
*must attach copy of appointment. |
3. |
Address: |
|
|
4. |
Phone Number(s): Home: |
Work: |
FAX Number: |
III. Representation Information (if any):
Please check one: Parent
School
1.Name of Your Attorney or Advocate
2.Address:
3. Phone Number: |
FAX Number: |
IV. Parent Information
1.Name of Parent(s):
2.Address:
3. Phone Number(s): Home: |
Work: |
FAX Number: |
V. Second Parent Information (if different from above):
1.Name of Parent(s):
2.Address:
3. Phone Number(s): Home: |
Work: |
FAX Number: |
NOTE: Federal law requires that you completely and accurately describe the reason(s) you are asking for a hearing and the outcome you are seeking. This includes a description of the student’s special needs, all
of the issue(s) you want the hearing officer to address, and the facts relating to those issues.
Failure to provide complete information may result in a challenge to the sufficiency of the Hearing Request.
VI. Description of the issue(s):
Please describe the student, the student’s IEP or educational program, and the reason(s) you are requesting a hearing. Please be as complete as possible including dates, names, and places when appropriate. Please identify all the issues you want the hearing officer to address. Incomplete information may limit the scope of the hearing. (Use additional pages if needed.)
(Description of the issue(s) continued from Page 2)
VII. Proposed resolution of the problem:
Please explain what you want the result of the hearing to be. (Use additional pages if needed.)
________________________________ |
__________ |
Signature of Person Requesting Hearing |
Date |
THIS FORM MUST BE SENT TO THE OPPOSING PARTY. AT THE SAME TIME, YOU MUST SEND A COPY OF THIS FORM TO THE BSEA. PLEASE SIGN BELOW TO CERTIFY THAT YOU ARE COMPLYING WITH THIS REQUIREMENT.
I certify that I am sending this hearing request form to the opposing party, and at the same time I am sending a copy to the BSEA.
I am sending this form to the opposing party by the following delivery method(s):
Please check:
Fax
Other (specify)
_____________________________________
Signature