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  • Test Step

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    jaime
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    The document outlines a process for teacher intervention in response to student behavior issues. It includes forms for private conferences with students, parent contact, counselor intervention, administration intervention, and office referrals. Each form includes fields for the date and time of behavior, behavior description, action taken, and notes sections for teachers, counselors, and administrators.

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    school steps

    Original Title

    test step

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    The document outlines a process for teacher intervention in response to student behavior issues. It includes forms for private conferences with students, parent contact, counselor intervention, administration intervention, and office referrals. Each form includes fields for the date and time of behavior, behavior description, action taken, and notes sections for teachers, counselors, and administrators.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    0 views6 pages

    Test Step

    Uploaded by

    jaime
    The document outlines a process for teacher intervention in response to student behavior issues. It includes forms for private conferences with students, parent contact, counselor intervention, administration intervention, and office referrals. Each form includes fields for the date and time of behavior, behavior description, action taken, and notes sections for teachers, counselors, and administrators.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 6

    1

    TEACHER INTERVENTION
    PRIVATE CONFERENCE WITH STUDENT

    1. Date of Behavior: Click or tap to enter a date.

    2. Time/Hour behavior occurred: Click or tap here to enter text.

    3. Describe the behavior: Click or tap here to enter text.

    4. Action Taken (check all that apply)

    ☐ Private/discreet discussion with student

    ☐ Verbal warning given to student

    ☐ Student seat changed

    ☐ Other (Please explain) Click or tap here to enter text.

    5. (If applicable) Date parent contact was made: Click or tap to enter a date.
    o ☐ Phone Call
    o ☐ Email

    6. Comments about conversation with parent:


    Click or tap here to enter text.

    7. TEACHER NOTES:
    Click or tap here to enter text.

    8. COUNSELOR NOTES:
    Click or tap here to enter text.

    9. ADMINISTRATOR NOTES:
    Click or tap here to enter text.
    2
    TEACHER INTERVENTION
    PARENT CONTACT

    1. Date of behavior: Click or tap to enter a date.

    2. Time/Hour behavior occurred: Click or tap here to enter text.

    3. Describe the behavior: Click or tap here to enter text.

    4. Action Taken (check all that apply)

    ☐ Private/discreet discussion with student

    ☐ Verbal warning given to student

    ☐ Student seat changed

    ☐ Other (Please explain) Click or tap here to enter text.

    5. (Required) Date parent contact was made: Click or tap to enter a date.
    o ☐ Phone Call
    o ☐ Email

    6. Comments about conversation with parent:


    Click or tap here to enter text.

    7. TEACHER NOTES:
    Click or tap here to enter text.

    8. COUNSELOR NOTES:
    Click or tap here to enter text.

    9. ADMINISTRATOR NOTES:
    Click or tap here to enter text.
    3
    COUNSELOR INTERVENTION
    1. Date of Behavior: Click or tap to enter a date.

    2. Time/Hour behavior occurred: Click or tap here to enter text.

    3. Describe the behavior: Click or tap here to enter text.

    4. Date parent contact was made: Click or tap to enter a date.


    PARENT CONTACT IS REQUIRED BEFORE REFERRING STUDENT TO COUNSELOR

    5. Comments about conversation with parent:


    Click or tap here to enter text.

    6. TEACHER NOTES:
    Click or tap here to enter text.

    7. COUNSELOR NOTES:
    Click or tap here to enter text.

    8. ADMINISTRATOR NOTES:
    Click or tap here to enter text.
    4
    ADMINISTRATION
    INTERVENTION
    1. Date of Behavior: Click or tap to enter a date.

    2. Time/Hour behavior occurred: Click or tap here to enter text.

    3. Describe the behavior: Click or tap here to enter text.

    4. TEACHER NOTES:
    Click or tap here to enter text.

    5. COUNSELOR NOTES:
    Click or tap here to enter text.

    6. ADMINISTRATOR NOTES:
    Click or tap here to enter text.

    5
    OFFICE REFERRAL
    1. Date of Behavior: Click or tap to enter a date.

    2. Time/Hour behavior occurred: Click or tap here to enter text.

    3. Describe the behavior: Click or tap here to enter text.

    4. TEACHER NOTES:
    Click or tap here to enter text.

    5. COUNSELOR NOTES:
    Click or tap here to enter text.

    6. ADMINISTRATOR NOTES:
    Click or tap here to enter text.

    6
    OFFICE REFERRAL
    1. Date of Behavior: Click or tap to enter a date.

    2. Time/Hour behavior occurred: Click or tap here to enter text.

    3. Describe the behavior: Click or tap here to enter text.

    4. TEACHER NOTES:
    Click or tap here to enter text.

    5. COUNSELOR NOTES:
    Click or tap here to enter text.

    6. ADMINISTRATOR NOTES:
    Click or tap here to enter text.

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