Student ID * Level * K-2 3-5 6-12 Questions When upset, this student becomes belligerent and disrespectful: * Multiple times a day Almost daily Weekly Maybe once a month Rarely This student gets in trouble with his friends: * Multiple times a day Almost daily Weekly Maybe once a month Rarely This student is overly influenced by peers: * Multiple times a day Almost daily Weekly Maybe once a month Rarely This student struggles to pay attention: * Multiple times a day Almost daily Weekly Maybe once a month Rarely This student receives frequent behavior reprimands: * Multiple times a day Almost daily Weekly Maybe once a month Rarely This student has difficulty making and keeping friends: * Yes - he is a loner He talks to others but is not close to anyone Not really He seems to have friends He has close friends This student gets in trouble trying to please or get the attention of others: * Multiple times a day Almost daily Weekly Maybe once a month Rarely This student offends other students and/or educators with his words: * Multiple times a day Almost daily Weekly Maybe once a month Rarely This student becomes easily angered and/or agitated: * Multiple times a day Almost daily Weekly Maybe once a month Rarely The student becomes physically or verbally aggressive: * Multiple times a day Almost daily Weekly Maybe once a month Rarely This student exhibits poor personal hygiene: * Multiple times a day Almost daily Weekly Maybe once a month Rarely email2 To prevent automated spam submissions leave this field empty.Submit