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Functional Behavior Assessment Form Template

Streamline Student Evaluations with Our FBA Template

Understanding a child's challenging behaviors can be overwhelming, especially when you need to find effective interventions. This Functional Behavior Assessment (FBA) template is designed for educators and specialists seeking to analyze the factors behind a child's behavior systematically. With clear prompts and structured sections, you'll gather essential information to identify triggers, evaluate needs, and develop support strategies, report behavior incidents, and enhance communication with parents. Start using the live template today for a straightforward approach to behavioral assessments.

Student full name
Date of birth
Grade/program
School or service setting
Your full name
Your role/relationship to the student
Please Specify:
Contact email
Primary concern behaviors for this referral
Describe the target behavior in observable, measurable terms
Provide common examples of the target behavior
How often does the behavior occur when opportunities are present?
Never
Rarely
Sometimes
Often
Always
Average duration when the behavior occurs
Less than 30 seconds
30 seconds to 2 minutes
2 to 10 minutes
10 to 30 minutes
More than 30 minutes
Varies/Not sure
Typical intensity/severity
Low
Moderate
High
Varies/Not sure
If safety risks exist, briefly describe concerns or required protocols
Does the behavior pose an immediate safety risk?
Yes
No
Common antecedents before the behavior
Times or activities when the behavior is most likely
Locations where the behavior is most likely
Who is usually present when the behavior occurs
Setting events that increase likelihood
How often are clear triggers identifiable?
Very rarely
Rarely
Sometimes
Often
Very often
Typical adult responses after the behavior
Describe any injury, property damage, or crisis procedures used
What typically happens for the student immediately after the behavior
Hypothesized function(s) of the behavior
Brief evidence supporting this hypothesis
Skill areas that may need to be taught
Communication methods the student currently uses
Speech
Gestures
Picture exchange/PECS
AAC device
Sign language
Writing/typing
Eye gaze
Other/Not listed
Does the student communicate needs before the behavior occurs?
Yes
No
Student preferred reinforcers and motivators
How long has this behavior been occurring?
Less than 1 month
1-3 months
3-6 months
6-12 months
1-2 years
More than 2 years
Not sure
Strategies or supports previously attempted
Which strategies have helped reduce the behavior?
Main barriers to consistent implementation
Existing data sources available
Team goal(s) for replacement or alternative behaviors
How likely are you to consistently implement agreed strategies?
Very unlikely
Unlikely
Neutral
Likely
Very likely
Do you have legal authority to provide this information?
Yes
No
Signature (type your full name)
Date signed
I confirm the information provided is accurate to the best of my knowledge
Strongly disagree
Disagree
Neither
Agree
Strongly agree
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Colorful paper art illustration depicting a Functional Behavior Assessment Form Template for FormCreatorAI article

When to use this form

Use this form when a student's behavior disrupts learning or safety and you need to pinpoint why it happens. It helps teachers, counselors, and school psychologists collect ABC data and turn patterns into a practical plan. For example, a child may leave class during math, call out after recess, or refuse group work when noise increases. Pair it with a Student observation form to log frequency, duration, and intensity across the day. Add a Classroom observation form to note seating, transitions, and task demands that might trigger the behavior. If incidents have led to office actions, the Discipline referral form helps you spot times, locations, and consequences that may be maintaining the behavior.

Must Ask Functional Behavior Assessment Questions

  1. What is the specific, observable behavior you want to address?

    Clear, measurable wording (e.g., hits peers with an open hand 3-4 times) reduces bias and improves consistency across staff. It lets you set a baseline and track change over time.

  2. When and where does the behavior most often occur, and what events come right before it?

    Identifying times, tasks, people, and setting events reveals reliable triggers. With this, you can adjust schedules, provide prompts, or change tasks before the behavior starts.

  3. What typically happens immediately after the behavior?

    Documenting adult and peer responses shows what might be reinforcing the behavior. You can then remove accidental rewards and add responses that support the skill you want.

  4. What is the most likely function (escape, attention, access to items/activities, or sensory), and what evidence supports it?

    A function hypothesis guides you to strategies that match the why, not just the what. Reviewing environment notes from a Classroom walkthrough form can strengthen your evidence.

  5. What replacement behavior will you teach, and how will you prompt and reinforce it?

    A clear alternative (e.g., raise hand to request a break) gives the student a workable path to the same outcome. Defining prompts and reinforcement schedules ensures every adult responds the same way.

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