Behavior Intervention Plan (BIP) Template
Student Name: ______________________________________ Date: ______________
DOB: __________________ Teacher/Case Manager: _______________________________________
Defined Behavior
Behavior Goals
Interventions and Frequency of Intervention
(This will support the teaching and learning of the goal.)
List persons who are responsible for services and monitoring performance.
Motivational and Instructional Interventions
Rewards and Reinforcements
Safety Interventions
Legal and Ethical Considerations in Maintaining Student Confidentiality
Resources
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Student Name:
Defined Actions
Behavior Objectives
Interventions and Intervention Frequency (This will support the teaching and learning of the goal.)
Persons in charge of services and performance monitoring should be listed.
Interventions in Motivation and Instruction
Rewards and Reinforcements
Safety Interventions
Legal and Ethical Considerations in Maintaining Student Confidentiality Resources
