RTI Referral Form - Craig High School 2026

The document is a referral form for students at Craig High School in Janesville, WI, designed to assess student performance and concerns. It includes sections for recording student information, attendance, skills ratings across various academic areas, classroom scores, primary concerns from teachers, strategies implemented to support the student, and additional relevant information. The purpose of the form is to facilitate communication and planning for student support.

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Click ‘Get Form’ to open the RTI Referral Form in the editor.
Begin by entering the student's name, teacher's name, and course/subject in the designated fields. This information is crucial for identifying the student and their academic context.
Fill in the number of absences and tardies. Accurate data here helps assess attendance issues that may affect performance.
Use the skills rating scale to evaluate the student’s abilities in various skill areas such as Reading Skills and Math Skills. Select a rating from 1 to 5 based on your observations.
Input recent classroom scores for tests, quizzes, or projects. This section provides a snapshot of the student's current academic standing.
List up to three primary concerns regarding the student. Be specific to ensure clarity in addressing these issues.
Document any strategies you have implemented to support the student, along with their responses. This information is vital for developing an effective intervention plan.
Finally, include any additional information that could assist in understanding the student better and tailoring support effectively.

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