Behavior Reflection Form
Name: ________________________________ Date: _______________________
Please answer in complete sentences using your best writing.
1. What did I do?
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2. How often does this happen? Circle one.
very often
sometimes
rarely
3. Why was this inappropriate? What problems did it cause?
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4. Two things I will do differently next time to help me are the following:
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Teacher Signature: ___________________________________________________________
Teacher Comments (optional): __________________________________________________
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Parent Signature: ____________________________________________________________
Parent Comments (optional): ___________________________________________________
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#3655 Creative Classroom Ideas