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SST Summary FormDate of Meeting ___________

Teacher__________________School ________________________________

Team_______________________________________________________________

Student _________________________________    

Primary Language______________ Grade_____ DOB ______Parents ______________­­­__        M­­­____     F ________

STRENGTHS

CONCERNS

KNOWN INFORMATION

KNOWN MODIFICATIONS (+/-)

QUESTIONS

STRAT

EGIES/

BRAIN

STORM

ACTIONS

WHO/

WHEN

Follow Up Date

Fish/Drolet/Leighty, Spring 200613

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