This form is used to refer a student to Tier 1 or Tier 2 services for Response to Intervention (RTI). Some districts refer to the RTI team as IAT (Intervention Assistance Team). Quality data is essential in order to make accurate instructional and behavior-related decisions for our students. Often times teachers have concerns regarding a student in their class, but they don't know how to share this information with the correct team member. This form is great to use for a first-step in the process of RTI, can be used as a data-collection tool and is very user-friendly. Collecting this data at the beginning of the RTI process ensures that all needed information is accounted for should the referral later lead to an evaluation for Special Education services. Enjoy!