Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the person involved in the incident at the 'Name' field. Make sure to provide accurate information for proper record-keeping.
3. In the 'Location' field, specify where the incident occurred by selecting one of the provided options such as Playground, Library, or Classroom. If necessary, you can write 'Other' and describe the location.
4. Next, fill in the 'Date' and 'Time' fields with the correct day and time when the incident took place.
5. Indicate the grade level of the student in the 'Grade' field. For this form, you may select from a range of grades, starting with K.
6. Enter your name as the referring staff in the designated field to identify the person completing the form.
7. Under 'Minor Problem Behavior,' select the relevant checkbox(es) that indicate the nature of the behavior. Options include inappropriate language, physical contact, defiance, and others.
8. Provide corrective actions or interventions taken in response to the minor problem behavior by selecting the appropriate checkbox(es) under 'Minor Problem Behavior.'
9. If applicable, move on to 'Major Problem Behavior' and select the relevant checkbox(es) that describe the serious nature of the incident.
10. In the 'Possible Motivation' section, select any of the motivations listed that may have influenced the person's behavior during the incident.
11. In the 'Administrative Decision' area, record any administrative actions to be taken by filling in the checkboxes as necessary.
12. Provide space for an administrative signature to confirm the completion of the review and decision process.
13. Indicate if there were other individuals involved in the incident by selecting from the list provided.
14. Use the 'Other Comments' section for any additional notes you wish to add regarding the incident or needs for follow-up.
15. Finally, have the parent or guardian sign and date the form in the specified fields.
16. Once all fields are filled out, users can save changes, download the form, print it, or share it as needed.

Complete the MI Macomb Intermediate School District Behavioral Referral Form online today!