This is a quick half page form I have students complete in the hall when their behavior is not part of a successful class environment. They complete this and then wait until I check on them in hall, I approve it, the students returns to the class with a blank slate. I have never had a student need more than one "Oops sheet". I gave out one this past year (second day of school).
Do not use for non-negotiables: hate language, physical issues, directed threats, etc.