Incident Record Sheet
What happened before this incident?
How did you respond?
Now I feel...
Happy
worried
frustrated
upset
Angry
upset
Angry
Now others feel...
Happy
worried
frustrated
What will you do to put this right?
What have you learnt from this? What will you do differently if
this ever happens again?
Signed by Child ........................................
Signed by Teacher .....................................
A copy of this sheet will be shared with parents by the teacher
and a copy kept by the Headteacher.