Collaborative Process Plan- In a School Based Team Setting

Collaborative
Process

Date _______________________________________

Evaluation Date___________________

Student _____________________________________

Teacher(s) _______________________

Attendees @ Meeting
________________________________________________________________________________
________________________________________________________________________________

Concerns

Strengths

Responsibility
& Trust:
introduced to
information

Evidence of the Problem/Situation

________________________________
________________________________
________________________________
________________________________
________________________________

Challenges/Triggers
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________

Current & Past Interventions and Assessments

Building
Respect &
Commitment:
gather
information

(Counselling, OT, SLP, Modified, Adapted, Designation, Learning Plan, Parents, community, etc.)

Reactive/Proactive Solutions
Where/How

Small Steps:
analysis
information &
brainstorm

By Whom

Desired Outcomes:

Created by Tonia Larson-Gagn, Spec. Ed.

Selecting the Solutions (Actions/Tasks)

Collaborative
Process

Action:

Expected Outcome:

Person(s) Responsible:

Outcome Achieved:

Completion Date:

Action:
Accountability:
strategy &
common
purpose

Expected Outcome:

Person(s) Responsible:
Outcome Achieved:

Completion Date:

Action:
Expected Outcome:

Person(s) Responsible:
Outcome Achieved:

Completion Date:

Parent(s)/Guardian, have been informed of the concern and the plan with SBT regarding possible
interventions. Date & Contact made by: _______________________________________________
Follow Up

Date & Person Responsible

Evaluate:
reflect &
assess

Other Information/Comments:

Created by Tonia Larson-Gagn, Spec. Ed.