RULER Reflections Sheets

If an incident occurs, the student may be asked to fill out one of the RULER based Reflections pages. There are forms A and B, based on the student’s level. Due to ADA policies, this is a break down of all questions on the one sheet form.

Reflection Sheet A

Circle the part(s) of STAR you did NOT follow:

Write or draw what happened?

How do you feel?

What could you do differently next time?

Circle how you think others were feeling.

Circle or draw how you can make it better.

Sorry Note, Say Sorry, Clean Up, other

Reflection Sheet B

1. What happened?
2. How did you feel? How do you think others feel? (Recognizing and labeling emotions)
3. Why do you have to fill out this form? (Understanding situation)
4. What choices could you have made differently? (Regulating Emotion/Meta Moment)
5. What steps do you need to take to make this right with our community? (Reflecting/Acting)
6. Mark on the Mood Meter and/or describe with words.
7. I was in the ______ quadrant. Now I am in the ______ quadrant.
   
   

Mood Meter