and Think Sheet

Name:______________________________________

Date:____________________________________________

Time:____________________________________________

This is a picture or description of what happened:

I chose to: ___________________________________________________________________________________________________________________________________________________

This hurt:     me – someone else – both.

                                   (circle one)

                                                                                   (over)

Next time, I will choose:

_______________________________________________________________________________________________________________________________________________________________________________________________________________________

Teacher’s comments:________________________________________________________________________________________________________________________

Parent’s comments:________________________________________________________________________________________________________________________

Signatures:

Student____________________________________

Teacher____________________________________

Parent______________________________________

Please return this form to the classroom teacher.