This can be used for a variety of classes from resource classes to homeroom classes. This is a form of documentation that the teacher will give to the class as needed or as often as necessary, it only takes a few minutes and is well worth the time.
If a class is out of control many will suffer the consequences.
I created this form and can tell you that if students know their peers are filling out a private evaluation of the class the behavior can change drastically.
If you are still struggling with behavior issues this type of documentation could help to strengthen your case, because let's face it the facts are not always welcomed.