Dante’s Den Processing Form: Did you do it Dante’s Way?
Name:
When did this happen?
morning
afternoon
Where were you?
Classroom
Hallway
bathroom
Cafeteria
Date:
Specialist
Off school grounds
Playground
What happened first?
I did not use nice words (disrespectful)
Somebody took something of mine
I called out in class
Somebody asked me to do something
I didn’t follow directions
I was not making safe choices
Other___________________________________________
Who was other person?
Another student
Teacher
Other
What did you do? Check all that apply
Hit/kicked
Yelled
Left without permission
Cried
Walked away calmly
Broke/threw something
Took something
Told adult
Went to another activity
Shared and took turns
Talked it out
Ignored it
Told them to stop
Apologized
Made a deal
Waited and cooled off
Other___________________________________________
How did you feel?
angry frustrated embarrassed sad scared worried
I don’t know/remember Other___________________
What were you thinking?
How strong was your feeling?
MORE ON BACK
Circle the face that fits…
DO WITH DANTE’S DEN STAFF
What Dante expectation did you not follow? (Check what applies)
Respecting others
Respecting Myself
Respecting My Environment
What were you trying to gain or avoid?
Did your behavior get you what you wanted?
Did your behavior cause you any other problems?
How well did you do it Dante’s way?
1 poorly
2 not so well 3 ok
4 good
5 great
--------------------------------------------------------------------------------------------What other positive choices could you have made to get you what you wanted and keep
you out of trouble?
Went to another activity
Shared and took turns
Talked it out
Ignored it
Told them to stop
Made a deal
Walked away calmly
Apologized
Waited and cooled off
Other_________________________________
To fix this problem I will