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PBIS Request for Assistance Form Student Name: Referred by: Date of Referral: Grade: IEP: Yes or Teacher/Advisory: 504 Plan: Yes or Title: Yes or No1. Check the main area(s) of concern: Problem BehaviorExternalInternal
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How to fill out pbis request for assistance

01
Start by downloading the PBIS Request for Assistance form from the official website.
02
Fill out your personal information including your name, contact details, and any identification numbers required.
03
Specify the type of assistance you are requesting, providing a detailed explanation of your situation or problem.
04
Attach any supporting documents or evidence that may be necessary to support your request.
05
Provide any additional information requested on the form, such as previous attempts at resolving the issue or any relevant deadlines.
06
Double-check all the information you have provided for accuracy and completeness.
07
Submit the completed form either by mail, email, or through an online submission system as indicated on the form.
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Keep a copy of the filled-out form, along with any supporting documents, for your records.
09
Follow up on your request if you do not receive a response within a reasonable timeframe.
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Be prepared to provide any further information or clarification as requested by the relevant authority handling your request.

Who needs pbis request for assistance?

01
Anyone who requires assistance from the PBIS program can submit a Request for Assistance. This may include individuals facing financial hardship, individuals with disabilities, victims of discrimination or harassment, or anyone seeking support and guidance in accessing their rights and entitlements under the PBIS program.
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PBIS request for assistance is a form used to seek help with Positive Behavioral Interventions and Supports.
School administrators, teachers, or parents may file a PBIS request for assistance.
To fill out a PBIS request for assistance, provide details about the behavioral issue, interventions attempted, and support needed.
The purpose of a PBIS request for assistance is to address challenging behaviors in a proactive manner.
Information such as student details, specific behaviors, interventions tried, and support needed must be reported on a PBIS request for assistance.
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