Learning Support Services Coaching Report

1. Weekly LSS Coaching Report

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* 1. Entry date

Today's Date

Date

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* 2. Contact date

Contact Date

Date

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* 3. Coach Phone Number (without symbols, spaces, dashes EX 4787572674)

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* 4. Coach lastname

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* 5. Coach firstname

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* 6. Student Phone Number (without symbols, spaces, dashes EX 4787572674)

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* 7. Student lastname

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* 8. Student firstname

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* 9. Contact method

phone

meeting

Other form of contact used

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* 10. Last week goal achieved

Yes

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* 11. 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

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* 12. Advised student of upcoming event:

Yes

Describe Event

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* 13. How can we help you/your student?

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* 14. Next session with the student is scheduled for

Date for next contact:

Date

Time

AM/PM

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