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Learning Support Services Coaching Report
1. Weekly LSS Coaching Report
1
. Entry date
MM
DD
YYYY
Today's Date
Entry date Today's Date Month
/
Day
/
Year
2
. Contact date
MM
DD
YYYY
Contact Date
Contact date Contact Date Month
/
Day
/
Year
3
. Coach Phone Number (without symbols, spaces, dashes EX 4787572674)
Coach Phone Number (without symbols, spaces, dashes EX 4787572674)
4
. Coach lastname
Coach lastname
5
. Coach firstname
Coach firstname
6
. Student Phone Number (without symbols, spaces, dashes EX 4787572674)
Student Phone Number (without symbols, spaces, dashes EX 4787572674)
7
. Student lastname
Student lastname
8
. Student firstname
Student firstname
9
. Contact method
Contact method
email
phone
meeting
Other form of contact used
10
. Last week goal achieved
Last week goal achieved
Yes
No
11
. Weekly Goal (Set a goal for one of the catagories listed below)
Weekly Goal (Set a goal for one of the catagories listed below)
School Engagement
Employment
Setting Expectations
Motivation
Validating Success
Self-Esteem
State the goal
12
. Advised student of upcoming event:
Advised student of upcoming event:
Yes
No
Describe Event
13
. How can we help you/your student?
How can we help you/your student?
14
. Next session with the student is scheduled for
MM
DD
YYYY
HH
MM
AM/PM
Date for next contact:
Next session with the student is scheduled for Date for next contact: Month
/
Day
/
Year
Hour
:
Minute
-
AM
PM
AM or PM
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