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Documenting Parent/Guardian Communication
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* Indicates required question
Date
Date is only necessary if form completed at a different time than the communication
MM
/
DD
Time
Time is only necessary if form completed at a different time than the communication
Time
:
AM
PM
Contact #
Your answer
Student Name
*
Choose
Option 1
Spoke to
Mom
Dad
Older sibling
Left Message
Wrong number
Number not in service
Other:
Who called Who?
Teacher initiates call
Teacher returns parent's call
Teacher calls in response to parent's note
Teacher responds to parent email
Parent initiates call
Parent returns teacher's call
Parent responds to teacher email
Other:
Reason for call
Don't know - teacher is returning parent's call
Report card grade
Report Card Conference
Failed test
Late to school/absences
Multiple late assignments
Disruptive behavior
Positive behavior
Unprepared for class
Lack of effort
Needs to come in for extra help
Incident at school
Other:
Next Steps
Will put together a growth plan
Offer extension on assignment
Offer re-do of assignment
Schedule a meeting for...
Other:
Notes
Your answer
Teacher will
Wait for parent to return call
Try to contact parent again
Other:
Submit
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