This is a form that students can use when they need to use the restroom or get a drink of water.
In elementary and middle school, valuable teaching time can be taken up with students constantly asking to go to the restroom. To eliminate that, as well as encourage my students to be more mature and act responsibly - I created this chart.
Students can go to the restroom as they need, filling out the chart accordingly. I kept all of the completed papers and saved them to discuss with students, or families, about abuse of the privilege if necessary.