For questions 5-12, please answer 3 or more as you reflect on the CIP conversation.

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* 1. Your name:

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* 2. Co-Panelist's name(s)

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* 3. Case Number

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* 4. CIP length:

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* 5. How did I act in a respectful manner (remembering that people are not willing to change behavior or learn unless they feel respected and in a safe environment)?

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* 6. How did I discuss my emotional impact of the incivility?

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* 7. Did I speak about how the crime affects me personally?

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* 8. How did I give the offender(s) an opportunity to take responsibility for the crime?

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* 9. Did I have a conversation with the offender about the incivility?

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* 10. How did I help the offender see his/her responsibility for civility in the community?

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* 11. What positive shifts did I notice in the parties regarding the incident or the panel itself?

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* 12. Were any issues raised by the youth or parent about their interaction with the police? If yes, please describe.

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