Behavior Reflection Form
Name: ___________________________
Date: ___________________________
1. What happened? (Describe the behavior. Example: I was talking during class.)
2. Why was this a problem? (Think about how it affected others, learning, or the class.)
3. How did my behavior affect others?
4. What could I have done differently?
5. What will I do next time to make a better choice?
Student Signature: ___________________________
Teacher Signature: ___________________________