Student Observation Form
Date & Time of Observation
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Student's Name
First Name
Last Name
Grade Level
Teacher's Name
First Name
Last Name
Subject
Observer's Name
First Name
Last Name
Reason
For academics
For behavior
For social
For study habits
Other
Evalulation
Kindly grade the following (1-Lowest and 5-Highest):
Rows
1
2
3
4
5
Describe the student's level of activity
1
2
3
4
5
Does the student listen to instructions?
6
7
8
9
10
Does the student follow the instructions?
11
12
13
14
15
Is the student get distracted easily?
16
17
18
19
20
Does the student distract his/her classmates?
21
22
23
24
25
Can the student stay in a single task?
26
27
28
29
30
Does the student give up easily in the topics?
31
32
33
34
35
Does the student work fast?
36
37
38
39
40
Is the student motivated to study?
41
42
43
44
45
Does the student able to socialize and play with others?
46
47
48
49
50
Does the student participate in class activities?
51
52
53
54
55
Is the student noisy in the classroom?
56
57
58
59
60
Can the student easily make friends with anyone?
61
62
63
64
65
Is the student cooperative?
66
67
68
69
70
Is the student happy?
71
72
73
74
75
Is the student confuse?
76
77
78
79
80
Does the student seek attention all the time?
81
82
83
84
85
Does the student follow instructions or directions?
86
87
88
89
90
Summary
Strengths
Weakness
Recommendations
Suggested strategies
Observer's Signature
Date Signed
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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Submit
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