I have used this form at the middle school level. It provides a place for teachers to check off (or initial) the behaviors they are seeing in the following areas: attendance, academic performance, conduct, and social skills. It also has a space for teachers of each discipline to write the student's grade for their class as well as a space for comments. I have found this form especially useful to use with team teachers and/or prior to a parent conference. It a student is having problems in multiple classes, it quickly shows the parent that is the case. I have also had parents request a copy to give to their child's doctor.
The assignment is a word document and can be edited as needed.