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To:
CC:
Principal
From:
Counselor
Date:
6/25/2015
Re:
Intervention
Person(s) Responsible
Data
Yelling and
aggression
towards adults and
peers
Principal
Conference
Summary
Counselor Notes
Behavior chart
Tallies of negative
behavior
Observer
Teacher
Classroom/School
Confidential
Date
Start time
End time
Interval length
=Percentage of occurence
10
11
12
Behavioral Definitions:
Date
Start time
End time
Interval length
=Percentage of occurence
10
11
12