Hassle Log
What is your first and last name? *
Your answer
What grade are you in? *
Time of Day *
Location *
Who asked you to fill out this form? *
What happened? Choose all that apply. *
Did you think first? *
Did you show respect? *
Did you show responsibility? *
Did you do your best? *
What did you do? *
Your answer
Has an adult talked to you about this before? *
How many times have you been talked to about this behavior? *
A lot of times
Did this involve another person? *
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