Help Ticket for Student Services

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Help Ticket for Student Services

Goal/Purpose: This Help Ticket is a quick way for staff to request assistance from the Student Support Team when a student/class/grade level needs academic, behavioral, emotional, safety, etc. support that cannot be fully addressed in the moment or in a quick hallway conversation. This form promotes timely help, shares important background (including strategies already tried), and creates a consistent record of support needed. The goal is to keep learning environments safe, positive, and productive while fostering collaboration between classroom staff and the support team! Thank you!

Person Filling Out This Form *

Student *

Crew Teacher *

Strengths of the Student(s) *

Nature of Concern: *

Grade-Level Support

Classroom-Based Support

Student-Specific Support

Required

Briefly Describe the Concern *

This Concern Relates Most to: *

Academic Support (reading, math, writing, etc.)

Behavior Regulation (disruption, refusal, aggression, impulse control, etc.)

Emotional Regulation (anxiety, crying easily, withdrawal, etc.)

Social Skills Support (conflict with peers, friendship skills, etc.)

Safety Concern (self-harm talk, threats, unsafe actions) - Stop and Immediately Connect to a School Counselor or School Psychologist!

Sensory Support (overstimulation, sensory break, etc.)

Medical/Health-Related

Select Help Requested: *

To Inform Others of an Initial Concern (FYI, no-to-limited action needed)

Help Problem Solving Individually with an SST Member

Support from SST at the next Level-Set Meeting

Help with a Plan B Conversation with a Student(s)

Help Setting up a Parent Meeting

Non-Evaluative Observation with an SST Member (Troyer, Tiefert, Suter, or Bachman) for Feedback/Collaboration

Required

Things I have Already Tried (helpful to know when problem-solving, so previously-tried solutions aren't focused on) *

Verbal reminder/ redirection

Positive reinforcement/ praise

Visual cues (schedule, checklist, hand signal)

Encouraged movement

Proximity or nonverbal prompt

Change of seating/ environment

Peer support/ partner activity

Academic adjustments (shortened task, alternative format of response)

Calm-down or safe space/ break space

Parent/guardian contact

Other

Required

If Individual Help Requested or an Observation is Requested, Please Indicate Best Times to Connect & Meet:

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