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Check In Check Out PBIS Tier form (editable)
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Description

For students in need of Tier 2 or Tier 3 interventions for behaviors, a Check In Check Out form can hold students accountable and remind them of their individualized goals.

For this form, assign a teacher to be your student's Champion. This person will check in with them every morning and every afternoon.

1. Check In - first thing in the morning prior to instruction. The Champion will review the student's goals and reinforce with specific feedback for the day.

2. Throughout the day, the student accumulate points towards whatever their individualized goals are.

3. Check Out - before dismissal and with a completed behavior chart. The Champion will help the student reflect on their day, evaluating if they made their goal, what they did well, and what they can improve tomorrow.

***This is NOT a behavior contract. This is to be paired with a behavior contract or with a student's individualized schedule with behavior objectives.

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Check In Check Out PBIS Tier form (editable)

Rated 5 out of 5, based on 1 reviews
5.0 (1 rating)
Sincerely Ms Sharp
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$1.00

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Digital downloads
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Grades
K - 5th

Description

For students in need of Tier 2 or Tier 3 interventions for behaviors, a Check In Check Out form can hold students accountable and remind them of their individualized goals.

For this form, assign a teacher to be your student's Champion. This person will check in with them every morning and every afternoon.

1. Check In - first thing in the morning prior to instruction. The Champion will review the student's goals and reinforce with specific feedback for the day.

2. Throughout the day, the student accumulate points towards whatever their individualized goals are.

3. Check Out - before dismissal and with a completed behavior chart. The Champion will help the student reflect on their day, evaluating if they made their goal, what they did well, and what they can improve tomorrow.

***This is NOT a behavior contract. This is to be paired with a behavior contract or with a student's individualized schedule with behavior objectives.

Report this resource to TPT
Reported resources will be reviewed by our team. Report this resource to let us know if this resource violates TPT's content guidelines.

Reviews

5.0
Rated 5 out of 5, based on 1 reviews
1
rating
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Great resource
Rated 5 out of 5
October 10, 2025
Met expectations
Great value
Great resource for special education teachers with behavior goals
Grace B.
118 reviews
Grades taught: PreK, K, 1st, 2nd
Student populations: Learning difficulties

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