When a general education teacher suspects that a student might need to be referred to the school's Intervention Assistance Team, this booklet can help the teacher document attempts at correcting the student's difficulties.
The cover page documents the student's name, school, grade level, school year, and names of the teachers providing interventions. The second page is where the teacher can document the student's strengths, weaknesses, main difficulty area, baseline data, a goal statement, and previous supports. Pages 3-7 make up the bulk of the booklet, which is a menu of interventions, accommodations, and modifications divided into 11 different categories. The teacher marks the approximate dates that an intervention was tried, rates the usefulness of the intervention, and writes notes on that intervention. The last page of the booklet is a Parent Contact Log with 6 places to document parent contacts. I developed the menu of interventions based on a career's-worth of Intervention Assistance Team meeting notes--these were the interventions that we recommended the most often.
When I have given this booklet to general ed. teachers during trainings, they have expressed genuine appreciation for such a comprehensive way to document what they are doing with challenging students. I also think that they like the half-size booklet format.
The file is in Adobe PDF, and it can be printed in booklet form by going to Print, then clicking on the Booklet button. It has 8 pages, but when printed in booklet form, it fits onto 2 pieces of paper (front/back, each page is printed in a half-page size).