How I Feel

Feeling like Im
going to explodeI need to calm
down.

Feeling angryI need to calm

down.

Feeling anxiousSomething is
bothering me.

Feeling fineEverything is OK.

Feeling happyThings are going

well.

(A, n.d.)
(Emojipedia, n.d.)

How I Feel Number

Behavior Action Plan

Dear Mr. Moyer,
Today, I ________________________ (name) chose to break our
class value _________________ by ________________________
As I think about my choice, I feel ___________________ because

Next time I will choose to:

_____________________________________________________
_____________________________________________________
_____________________________________________________
My consequence for actions may be:
_____________________________________________________
_____________________________________________________
This consequence will help me remember to make a better choice
because:______________________________________________
_____________________________________________________
_____________________________________________________
Im very sorry.
Sincerely,
____________________

_______________________

(Sign name/date)

(Mr. Moyer signature/date)

Teacher Response:

Behavior Action Plan

To the parents of _____________________

Attached to this letter is a copy of the Behavior Action Plan that your
child completed today. Please look it over, give any feedback or
suggestions, and return this top sheet signed.
Thank you very much for your support!
Mr. Ryan Moyer

Parent Feedback:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________

Parent signature _______________________

Date _____________________