MTSS RTI Intervention Log Editable

About this resource

The paper behind Tier 2 and Tier 3 support, in one fillable PDF: the concern, the plan, the session log, the group log, the progress data and graph, a fidelity check, the data review notes, the tier record, the family letter and contact log, a caseload tracker, an intervention menu your school fills in, and a filled example. Type the plan and the roster once, Save As per student, pen the sessions and the scores.

WHAT IS INCLUDED - 18 pages, 822 type-in fields

Setup

• How the Log Works - the five-step loop (concern, plan, log, monitor, decide) with the page for each step, and a blank table for your district's own tier definitions, timelines and who decides a move
• How the Type-In Fields Work - one page, so nobody emails you
• Intervention Menu - 12 rows your school fills once: area, tier, intervention name, who delivers it, group size, minutes by days, progress measure

Concern And Plan

• Student Concern and Referral Form - student, grade, teacher, area, the concern in observable words, 4 rows of what was tried in class and what happened, a data-attached checklist, strengths, who received it
• Intervention Plan - one student: the goal in measurable words with a frame, 8 plan rows (intervention, who, when, how often, minutes, group size, tier, what must happen every session), progress measure, baseline, target, aim line per week, review date

Logs

• Intervention Session Log - 16 rows: date, minutes, skill, activity, student response, initials, with a minutes total at the foot
• Weekly Intervention Log, Group Version - 6 students by Monday to Friday, a present mark and the minutes in each cell, weekly minutes per student, a sessions-held row, and a card for the skill taught each day

Monitoring

• Progress Monitoring Data Sheet - 12 rows: date, week, measure, score, the aim line value for that week, above or below, notes
• Progress Graph - twelve weeks, 0 to 100 labeled to your measure, a date, score and aim line row underneath
• Fidelity Check - 10 items you type from the plan by 4 observation dates, Y or N, items marked Y, percent, who checked and who was told

Deciding And Telling

• Data Review Meeting Notes - 8 student rows: data reviewed, the decision (continue, intensify, fade, refer), the reason in data terms, next review, with the four decisions defined on the page
• Tier Movement Record - one student across the year, 8 rows: date, from tier, to tier, decision, reason in data terms, decided by, and a line for your district's rule
• Parent Communication about Intervention - a letter with the blanks to fill, and a contact log of 8 rows
• Caseload Intervention Tracker - 14 rows: student, grade, tier, area, intervention, start, review, status
• A filled example for an invented third grader: the plan, six session rows with the minutes added, four data points against the aim line, and the decision that came out of them

What This Is, And What It Is Not

It is a fillable PDF. Open it in a PDF reader, click a line, a box or a cell, type, press Tab to move on, and Save As once per student. It works offline with no account or subscription. It is NOT a Google Sheets file, a Google Doc or an Excel workbook, and it does not add the minutes or draw the graph.

It is not a definition of the tiers, a timeline, or a rule for when a student moves between tiers or is referred on. Those belong to your district, and page 3 has a table to write them in. It is not a curriculum: the menu is empty until your school fills it. Every page is the working paper that shows what was done, how often, and what the numbers did.

Who This Is For

General education teachers who deliver or refer for Tier 2 support, interventionists running small groups, MTSS and RTI coordinators who need every student's plan, minutes and data on the same forms, and the teams that meet to decide.