This is an exit (or entry) slip that can be used for every lesson. I've included both checkmarks, as well as smiley faces so that this can be differentiated by grade or students. This fits several areas of Danielson's framework including 1e: Designing Student Assessment (creating complex formative assessments and using these assessments intentionally) and 3d: Using Assessment in Instruction (integrated formative assessment and student self assessment).
The first box can be used to write an I can statement, an objective, or a question. Teachers can fill this in before the lesson or students can do this during the lesson. Students can then provide an answer, explanation, or example in the box.