A client - either assigned to you or not has had a crisis event. They displayed aggression or self injury behavior and either in passing or directly you were involved with event.

We are tracking client relation and its influence to crisis event timeline - all data is anonymized, and what you provide will not be traceable back to you.

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Staff ID

Student ID

Approach / Avoidance

How does this student typically behave toward you in terms of seeking or avoiding interaction?

1 - Frequently seeks me out

2 - Sometimes seeks me out

3 - Neutral / no clear pattern

4 - Sometimes avoids me

5 - Frequently avoids me

Engagement Quality

When interacting with this student, how would you describe the quality of engagement?

1 - Very positive (engaged, cooperative, comfortable)

2 - Mostly positive

3 - Mixed / neutral

4 - Mostly negative (resistant, disengaged)

5 - Very negative (frequent refusal, distress, conflict)

Confidence Rating

How confident are you in your ratings for this student?

1 - Very confident

2 - Somewhat confident

3 - Unsure

4 - Low confidence

Aggression Intensity

When this student becomes aggressive toward you, how intense is it typically?

Intensity (1 to 10)

1 - No aggression

3 - Mild (e.g., light contact, minimal risk)

5 - Moderate (clear attempts, manageable)

7 - High (forceful, requires intervention)

10 - Severe (risk of injury, significant escalation)

Additional Context / Patterns (optional)

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