Office Referral Form

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Effective Office Referral Forms


Welcome back. Last month I showed you how I level behaviors. I used these levels to develop office referral forms. It is important to have a well-developed office referral system. A well-developed system allows you to easily organize and analyze behavior. Before you can change behavior, you have to analyze it so you can understand what is happening.

For example, I worked with a school that would inconsistently labeled fights as “school fight”, “fighting”, “student fight”, “students fighting”, etc. No software will accurately sort this information. The only way we could get an accurate count of how many fights were in school was to manually count them. HUGE TIME DRAIN! Once we cleaned this up, we discovered the bulk of the fights were happening in the boys’ bathroom after lunch. We quickly changed bathroom procedures and supervision to eliminate that problem.

Here are three sample forms for Office Referrals:

ORF second

The first has an emphasis for the FUNCTION of the student’s behavior. Notice the question:

What is the function of the behavior?



Remember, all behavior has a function. It is to avoid something or obtain something. In order to change a student’s behavior, you have to understand the function. See my post Quick & Easy Functional Behavior Assessment.



All three samples have check boxes for Staff Member Interventions. This is to remind staff that many strategies exist before an office referral (note: all Level 3 behaviors are immediate referrals). If a student has a behavior plan, it should be noted (and reviewed). The Administrative Actions is a list of consequences ranging from less severe to most severe.

ORF detenThe next Office Referral form was used in a middle school that wanted it in triplet form to use as detention notice.









ORF 1The last sample form is for a secondary school. Teachers wanted a place to write a comment.








These forms are available in Word and are editable. You can personalize it for your school. By taking the time to clean up what behaviors go to the office and using consistent office referral form, you will be able to analyze behaviors. This fall, I will show you how to analyze behaviors using an Excel Pivot Table. It’s worth the wait….