Office Discipline Referral (ODR) Teacher/ Staff
Digitally complete and submit form when a student demonstrates a behavior problem. For *Minor Behavior Problem, complete and Submit form; the student remains in class. Three minors of the same behavior= major. **Major Behavior Problem, print the completed form and send student with form to an administrator. You may choose to request campus security to accompany the student.
Student Name *
Your answer
Student ID *
Your answer
Grade *
Date: Click on the Arrow for Drop-Down Calendar *
School Period *
Time *
Location *
Referring Staff *
Your answer
Possible Motivation *
Others Involved in Incident *
*Minor Behavior Problem *
Notes on Student's Behavior
Your answer
Notes on Teacher action
Your answer
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