I created this behavioral form to use with my preschool students and continue to use it today with my kindergarteners. I found that other forms online were difficult for early learners to understand, because they were not readers yet. I used pictures to help describe the action. My students circle which behavior they did, and then circle the behavior they should do next time. We discuss what it means to be safe, kind, and/or responsible, and sign the sheet.

This form can be used for behavior documentation and/or parent communication. When I send it home for parents, I just make sure to add any details of what happened in the blank space.

This can be used with behavioral programs such as Positive Behavior Support and/or Conscious Discipline.