RALLY Program Resources
Forms and Documents



Binder Documents:
Binder Index
a guide to structuring the RALLY practitioner binder
Student Profile
an introductory tool to be used to get to know a student
Daily Log
a day-to-day record of a practitioner’s day on-site
Session Summary
a record of an individual meeting with a Tier 1 student
Group Session Notes
a form to record and summarize the plans and process of a group run by a practitioner
Contact Log
a form to record and track phone calls or meetings with the families of students
Wrap Up Documents:
Tier 1
a form that is filled out for each Tier 1 student to summarize services provided
Tier 2
a form that is filled out so that Tier 2 students can get follow-up, and to record services
Groups
a summary of groups run by a practitioner
Afterschool Groups
a description of practitioner services during afterschool hours
Tier Time Distribution
a form that each practitioner fills out to show how they allocate their on-site time by tier
  Sample Documents:
Student Referral: a form that can be given to teachers to initially refer students for RALLY services
Supervision Documents:
Learning Contract
Transcript Guidelines
Transcript Sample
Ant Diagram
Satisfaction Surveys:
Mid-year Practitioner Survey
Practitioner Survey
Administrator Survey
Mid-year Teacher Survey
Teacher Survey
Parent Survey
Student Survey
Supervisor Survey



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Related Links: Harvard University - McLean Hospital - RALLY

© 2006 Program in Education, Afterschool & Resiliency - Last Updated: 10/12/06