Behavior Report

__________________________
(Date)

Dear ____________________________,

I had a problem at school today that we need to discuss. Today I ___________________

_________________________________________________________________
_____________________________________.____________________________

I know this is not safe. respectful. responsible. (Circle at least one)

I think I did this because _______________________________________________

_________________________________________________________________

Next time I will make a better choice. I will try to _____________________________

_________________________________________________________________
_________________________________________________________________

Because of the choice I made, I will/had to: ___________________________________

_________________________________________________________________

I’d also like you to know that _____________________________________________

_________________________________________________________________

Please sign and help me remember to return it to school tomorrow. I will be

returning it to ________________ before recess. You can contact this teacher
by Dojo, email, or by calling the school office to arrange a time to chat if you have
any questions.
________________________
________________________

Parent Signature ______________________ Date ______________

You may write a message on the back if needed. Thank you.
Behavior Log

Choose joy
anyway.
Student Date Spoke to:

Via

Topic:

Details

Student Date Spoke to:

Via

Topic:

Details