This is an invaluable part of my classroom - we do it 2-5 times a month, all year. It is a self-assessment tool for students to review their current grade, consider why it is what it is, and state what their target grade is. My students are very at-risk so self-assessments are particularly valuable. (Higher achieving students do not need this sort of instrument I suspect.)
This is how I do it: Almost every Monday I give each student a progress report, then they take out their Grade Tracking Forms and fill it out for that date. There should be an entry on the tracking form for every date I give them a progress report. I keep one of these Grade Tracking Forms on the wall and every time we fill it out (most Mondays) I write the date on it. that way students always how many entries they should have. I have my students turn them in at the end of the semester for points.
Can be used for any grade level, any class subject.
This is a Word doc so you can make adjustments to fit your needs.