Who qualifies for a 504 plan?

A student qualifies for a 504 plan if they have a physical or mental impairment that substantially limits one or more major life activities. This includes ADHD, learning disabilities, anxiety, depression, physical disabilities, chronic health conditions (asthma, diabetes, epilepsy), and many other conditions. The impairment does not need to affect academic performance directly — it just needs to substantially limit a major life activity.

Can parents request a 504 plan?

Yes. Parents or guardians can request a 504 evaluation in writing at any time. The school is required to respond to the request and, if it suspects the student has a disability, must evaluate the student. Schools cannot refuse to evaluate simply because the student is performing adequately academically.

How long does a 504 plan last?

504 plans must be reviewed at least annually. There is no automatic expiration — the plan remains in effect until the student no longer needs accommodations, the team determines the plan is no longer appropriate, or the student's circumstances change significantly.

Do 504 accommodations apply to standardized testing?

Accommodations apply to school-administered tests. For large-scale standardized tests (SAT, ACT, AP exams), students must apply separately to the testing agency for accommodations. Having a 504 plan is supporting evidence for these applications but does not automatically guarantee approval.

Free 504 Plan Template — Fill Out & Download Instantly

Free — No Sign-Up RequiredPDF & WordUpdated April 18, 2026

A 504 plan is a formal accommodation plan created under Section 504 of the Rehabilitation Act of 1973 that provides students with disabilities equal access to education by ensuring they receive appropriate accommodations, modifications, and supports in the general education environment. Unlike an IEP (Individualized Education Program), a 504 plan does not require the student to need specialized instruction — it addresses students whose disability substantially limits a major life activity (such as learning, concentrating, reading, or communicating) but who can succeed in a regular classroom with the right accommodations.

⚠️ Legal Disclaimer: This template is attorney-reviewed and built to US legal standards. It does not substitute for professional legal advice. For complex situations, we recommend consulting a licensed attorney.

Document Completeness0%

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

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SECTION 504 ACCOMMODATION PLAN

════════════════════════════════════════

STUDENT INFORMATION

════════════════════════════════════════

Student Name: [Student Full Name]

Date of Birth: [Student Date of Birth]

Grade: [Grade Level]

School: [School Name]

════════════════════════════════════════

DISABILITY INFORMATION

════════════════════════════════════════

Nature of Disability: [Nature of Disability]

Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) prohibit discrimination against individuals with disabilities. This student has a physical or mental impairment that substantially limits one or more major life activities, including learning, concentrating, reading, and/or communicating. This 504 Plan is developed to ensure the student receives equal access to educational programs and activities.

════════════════════════════════════════

PLAN DETAILS

════════════════════════════════════════

Meeting Date: [504 Team Meeting Date]

Plan Start Date: [Plan Start Date]

Plan End Date: [Plan End Date]

Parent / Guardian: [Parent / Guardian Name]

Case Coordinator: [Case Coordinator / 504 Coordinator Name]

════════════════════════════════════════

STUDENT PROFILE

════════════════════════════════════════

Strengths:

[Student Strength 1]

How the Disability Affects the Student in the Educational Setting:

[Area of Concern 1 (how disability affects learning)]

════════════════════════════════════════

CLASSROOM ACCOMMODATIONS

════════════════════════════════════════

The following accommodations shall be provided to [Student Full Name] in all applicable classroom settings:

1. [Accommodation 1]

2. [Accommodation 2]

All teachers of record are responsible for implementing the accommodations listed above. Teachers should document implementation and contact the case coordinator with any concerns.

════════════════════════════════════════

TESTING AND ASSESSMENT ACCOMMODATIONS

════════════════════════════════════════

[Testing Accommodations]

These accommodations apply to classroom tests, quizzes, and standardized assessments administered by the school (including state assessments, where applicable under state law).

════════════════════════════════════════

PLAN REVIEW

════════════════════════════════════════

This 504 Plan will be reviewed [Review Frequency] and whenever there is a significant change in the student's needs, placement, or performance. The plan must be reviewed at least annually. Any team member may request a review meeting at any time.

════════════════════════════════════════

TEAM SIGNATURES

════════════════════════════════════════

By signing below, each team member acknowledges participation in the development of this plan and agreement with its contents. Parent/guardian signature indicates consent for plan implementation.

Case Coordinator:

_______________________________ Date: _______________

[Case Coordinator / 504 Coordinator Name]

Parent / Guardian:

_______________________________ Date: _______________

[Parent / Guardian Name]

General Education Teacher:

_______________________________ Date: _______________

Name / Subject: _______________

Administrator:

_______________________________ Date: _______________

Name / Title: _______________

════════════════════════════════════════

NOTICE TO PARENTS / GUARDIANS

════════════════════════════════════════

You have the right to: (1) participate in the development and review of this plan; (2) review and receive a copy of this plan and all related records; (3) request changes to this plan at any time; (4) file a grievance if you believe the plan is not being implemented; and (5) seek independent evaluation at your own expense. If you disagree with the school's decisions regarding your child's 504 Plan, you may request a meeting with the principal, contact the district's 504 coordinator, or file a complaint with the U.S. Department of Education Office for Civil Rights (OCR).

Document Completeness0%

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

Student Full Name*

Student Date of Birth*

MM/DD/YYYY

Grade Level*

School Name*

Nature of Disability*

504 Team Meeting Date*

MM/DD/YYYY

Plan Start Date*

MM/DD/YYYY

Plan End Date*

MM/DD/YYYY

Parent / Guardian Name*

Case Coordinator / 504 Coordinator Name*

Student Strength 1*

Area of Concern 1 (how disability affects learning)*

Accommodation 1*

Accommodation 2*

Accommodation 3

Accommodation 4

Accommodation 5

Testing Accommodations*

Review Frequency*

What Is a 504 Plan Template?

When Do You Need It?

A 504 plan is needed when a student has a documented physical or mental disability that substantially limits a major life activity and that requires accommodations to participate fully in school. Parents or guardians typically initiate the 504 process by submitting a written request to the school. The school then convenes a team — typically including the parents, general education teachers, school counselor, and an administrator — to evaluate the student's needs and develop the plan.

What's Included in This Template

Student name, date of birth, grade, and school
Nature of the disability and how it affects learning
Meeting date, plan start and end dates
Parent or guardian name
Case coordinator name
Student strengths and areas of concern
Up to 5 specific classroom accommodations
Testing and assessment accommodations
Review frequency
Signature lines for team members

How to Fill It Out

Enter Student Information — Provide the student's full legal name, date of birth, current grade level, and school name. These identifiers link the plan to the specific student and school year.

Describe the Disability — Briefly describe the student's disability (e.g., ADHD — predominantly inattentive type, generalized anxiety disorder, Type 1 diabetes). The description should be clinical but understandable. This establishes the legal basis for the 504 plan.

Enter Meeting and Plan Dates — Record the date of the 504 team meeting and the plan's start and end dates. Most 504 plans cover one academic year. Note the parent/guardian name and the case coordinator who will oversee plan implementation.

Document Strengths and Concerns — List the student's academic and personal strengths — these should inform how accommodations are designed. Then describe areas of concern — specific academic or behavioral challenges directly caused by the disability.

Specify Accommodations — List specific, actionable accommodations the student will receive in the general education classroom. Examples: extended time on assignments, preferential seating near the front, breaks as needed, use of a planner, reduced workload, frequent check-ins, oral instead of written responses.

Address Testing Accommodations — Describe any special accommodations for tests, quizzes, and standardized assessments. Common testing accommodations include extended time (1.5x or 2x), separate testing room, reader or scribe, calculator, and breaks during testing.

Legal Requirements & Notes

Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act require schools receiving federal financial assistance to provide appropriate accommodations to students with qualifying disabilities. 504 plans do not require students to have an IEP or to be in special education. The 504 process must comply with procedural safeguards, including notice to parents and the right to contest decisions. State laws may impose additional requirements. This template is for educational guidance only and does not constitute legal advice. Schools should consult with their district's legal counsel and 504 coordinator.

Frequently Asked Questions

An IEP (Individualized Education Program) is for students who need specialized instruction in addition to accommodations, and is governed by IDEA (Individuals with Disabilities Education Act). A 504 plan provides accommodations and modifications within the general education setting and is governed by Section 504 of the Rehabilitation Act. 504 plans are generally easier to obtain and cover a broader range of disabilities.

Free 504 Plan Template — Fill Out & Download Instantly

SECTION 504 ACCOMMODATION PLAN

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STUDENT INFORMATION

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════════════════════════════════════════

DISABILITY INFORMATION

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PLAN DETAILS

════════════════════════════════════════

════════════════════════════════════════

STUDENT PROFILE

════════════════════════════════════════

════════════════════════════════════════

CLASSROOM ACCOMMODATIONS

════════════════════════════════════════

════════════════════════════════════════

TESTING AND ASSESSMENT ACCOMMODATIONS

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════════════════════════════════════════

PLAN REVIEW

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════════════════════════════════════════

TEAM SIGNATURES

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════════════════════════════════════════

NOTICE TO PARENTS / GUARDIANS

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What Is a 504 Plan Template?

When Do You Need It?

What's Included in This Template

How to Fill It Out

Legal Requirements & Notes

Frequently Asked Questions

Related Templates

IEP Template (Individualized Education Program)

Lesson Plan

Weekly Lesson Plan