Student Behavior Observation Checklist Form
Use this form to record and review student behavior observations during class. All responses are for educational observation purposes only.
Educator Name
*
First Name
Last Name
Student Name
*
First Name
Last Name
Date of Observation
*
-
Month
-
Day
Year
Date
Class/Subject
*
Observed Positive Behaviors (select all that apply)
Participates actively
Follows instructions
Works cooperatively
Shows respect to others
Stays on task
Other
Observed Challenging Behaviors (select all that apply)
Disrupts class
Does not follow instructions
Off-task behavior
Uncooperative with peers
Shows disrespect
Other
Level of Engagement
High
Moderate
Low
Peer Interaction
Positive
Neutral
Challenging
Additional Comments or Notes
Recommended Next Steps
Submit Observation
Should be Empty: