Student Reflection
Form to be filled out by student before they reenter classroom.  
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First name: *
Last name: *
Teacher *
Grade: *
What happened? *
Did your response make the problem bigger or smaller? *
What were you thinking at the time? *
What have you thought about since? *
Who has been affected by what happened? How have they been affected? *
How have you been affected by this? *
What has been the hardest part about this for you? *
What needs to happen to help make things right? *
Here are some ways I could have helped make the problem smaller before it got this big: *
Required
Were you able to turn your day around?
Clear selection
What do you think should be the consequences for your actions?
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