To go with the clip chart behaviour management system. When students reach red (parent contact), they fill one of these out by reflecting on how they reached the colour red and how they can make sure they stay off red next time.
Their is a spot for the teacher to sign and date; as well, as they parent. There is also a box for parent's comments.
I usually photocopy the sheet before I send it home for my records. In case it doesn't come back and I need to phone the parents.