CORE Referral & Information Gathering

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The CORE Team meets weekly to discuss students who are struggling and have been referred to this Level 2 Intervention by classroom teachers. After the initial CORE meeting, and depending on the nature of the concern, either an Initial Plan of Action will be shared with teachers, or an SBTM will be scheduled and teachers will be invited to attend.

Email *

The information collected through this survey will be used to determine students in need of intervention. You may be contacted for additional information about a referred student if/when they are discussed at a weekly CORE meeting.

Please enter YOUR name below. *

In the space below, please enter the name of the STUDENT that you would like to refer to the CORE team. *

Note: If you have concerns about more than one student, please complete and submit this form for each student.

Does this student identify as Aboriginal? *

Yes

Unsure

What is the student's current %, letter grade, or proficiency level in your course? *

What is the student's current effort in your course? *

Good

Satisfactory

Needs Improvement

A CORE Referral is a Level 2 Intervention. What Level 1 supports and interventions have you already implemented to support this student? *

Implemented universal and essential supports

Met with student to discuss concerns

Offered CEA support during class (If there is a CEA assigned to your class)

Offered support outside of class time

Encouraged the student to GRIT block

Consulted student's case manager or counsellor

Accessed ILC Teacher Supports

Consulted with an Aboriginal Education Worker

Involved administration

No supports or interventions have been necessary

Other:

Required

Beyond regular reporting (interims and report cards), have you contacted parents to discuss your concerns? Please note the date of contact below.

YYYY

Briefly outline the parent's response. *

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