Refocus Response Sheet

1. What Core Value word am I having a challenge with and why? _______________________________________________________________________________________________________________________________________________________________________________________________________

2. How did my actions affect others? ____________________________________________________________________________________________________________________________________________________________________________

3. What could I do better next time in order to improve? ______________________________________________________________________________________________________________________________________________________

Signed by: ________________ _________________
Teacher Student

Reason for Refocus Response Sheet (Teacher): ______________________ ____________________________________________________________________________________________________________________

Guardian’s Signature: ________________