This is a behavior reflection sheet I made for use with PBIS. It is appropriate for both middle and high school students.
Immediately after a student fails to meet expectations, I have them complete this reflection. The sheet asks them to explain what they were doing and what expectation was not met. Students then explain why that expection is in place and what they should have done instead or a plan for to correct the behavior in the future.
The bottom of the sheet leaves space for a teacher note to parents (optional) and lines for teacher, parent, and student signature.
*I explain and model how to fill out this sheet at the beginning of the year before I need to use it.