Intervention Request
This form is used to request the development of an intervention in Performance Matters.
School Name *
Organization Settings
School Level *
Intervention Program *
Your answer
Area of Focus *
Scoring Tool(s) *
Please Note: When a scoring tool is included with the program of choice, it is highly encouraged that this tool is used for progress monitoring. In the event one is not included, the scoring tool selected should align to the instruction provided during the intervention.
Your answer
Units of Measure *
Required
Duration *
Please Note: If and when the evidenced based program lists a duration of time for the intervention to be effective, it is highly encouraged that the interventionist stay true to the recommended time. When selecting the duration, please consider the time needed for the intervention to be effective.
Required
Frequency *
Please Note: If and when the evidenced based program includes the frequency for which the intervention should occur for effectiveness, it is highly encouraged that the interventionist stay true to the recommended frequency. When selecting the frequency, please consider how often instruction needs to occur for the intervention to be effective.
Required
Group Size *
Required
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