PDF FORMS

Preventive Behavioral Threat Assessment K–12 School Site Level 1 Assessment Forms

• Level 1 Protocol 2021 Generic Fillable PDF (11/01/21)​

• Threat Response Dismissal Form (01/22/2020)

• 24J Guide (10/21/2019)

• Plan to Protect Targeted or Victimized Student Fillable PDF (10/11/2019)

• Notification Log Fillable PDF (10/11/2019)

• Recommended Notification Letter Fillable PDF (10/11/2019)

• Level 1 Student Interview (10/11/2019) 

• Level 1 Student Witness Interview Fillable PDF (10/11/2019)

• Parent Interview Fillable PDF (10/11/2019)

• Teacher Questionnaire Fillable PDF (10/11/2019)

• Risk Factors STAT Brochure (10/11/2019)

​

Preventive Behavioral Threat Assessment K–12 Community Team Level 2 Assessment Forms 

• Level 2 LEUR Investigation Fillable PDF (11/01/2021)

• Level 2 Student Interview Fillable PDF (10/11/2019)

• Level 2 Law Enforcement Fillable PDF (10/11/2019)

• Level 2 Mental Health Fillable PDF (10/11/2019)

​

Preventive Behavioral Threat Assessment K–12 Community Team Meeting Forms

• STAT Form Example: MOA for STAT 

• STAT Form Disclaimer (11/25/2019)

• STAT Form Example: Confidentiality Agreement (11/25/2019)

• STAT Reference and Review (11/25/2019)

​

Suicide Risk Assessment K–12 School Site Level 1 Forms 

• SRA Spanish Parent/Guardian Interview Fillable Form

• Student Coping Plan (07/30/2019)

• SRA Teacher Fillable Questionnaire

• SRA Secondary Level 1 Protocol Student Interview

• SRA Student Safety and Support Fillable Plan (07/30/2019)

• SRA Addendum Level 1 Protocol - Student Interview Fillable Form (11/2020)

• SRA Flow Chart (07/03/2019)

• SRA Community Witness Fillable Interview Form (11/2020)

• SRA District Staff Fillable Questionnaire (11/2020)

• SRA Elementary Level 1 Protocol - Student Interview Fillable Form (11/2020)

• SRA Peer Witness Fillable Interview Form (11/2020)

• SRA Parent/Guardian Fillable Interview Form (11/2020)