Referral Form

Brilliant Behaviors Referral Form

This form asks teachers to reflect on her or his class after a series of formal observations or simply after having been their teacher for a minimum of four weeks. Impressions of individuals in the group are based on an accumulation of evidence, rather than observations after a single activity.

A support or resource-teacher can distribute this form to a teacher who is familiar with a group of students with a request that it be completed within a particular time frame. Allow at least a week, then follow up if forms have not been returned by some teachers. When distributing the form you may want to distribute some of the activities recommended to stimulate Brilliant Behaviors along with it. These are to be offered as options and as examples of the types of open-ended activities that provide contexts suitable for observations. Teachers may have favorites of their own. If they do, ask for copies and add them to your Tool Kit.

It is not crucial that three names be given for each characteristic on the Referral Form. Some may be left with no entries because the teacher has simply not seen them . . . yet. It is not likely that an accurate sense of individuals within that group can be achieved until the fourth or fifth week of the term or year. Even then, the rater should be prepared to be surprised in the future.

This form should be distributed with a cover sheet indicating the deadline for returning it and perhaps a few of the activities mentioned at the end of this chapter in order to facilitate its use. This information can contribute to subsequent decisions about differentiation and/or placement alternatives.

Download the Brilliant Behaviors Referral Form here.