Embedded Files
All documents are downloadable.
Click to download and complete.
Upon completion of your investigation and assessment, store all documentation in a confidential folder (electronic or printed copies).
LEVEL 1 PROTOCOL
LEVEL 1 PROTOCOL
Click to download this Level 1 fillable form.
When complete, save it to your confidential file system.
This file includes safety suggestions and guidance for requesting a Level 2 assessment.
LEVEL 1 VIDEO
LEVEL 1 VIDEO
Each time you convene a level 1 meeting, play this video so the team remains refreshed on threat assessment protocols and practices.
Questionnaires
Questionnaires
Student Questionnaire
Student Questionnaire
Guidance:
These questions are designed for students in grades 6-12 (the K-5 questionnaire can be downloaded below).
Ideally, an administrator or school counselor will lead the conversation.
Note the responses as accurately as possible on the fillable form.
NEVER: Hand the interview to the student and ask them to complete it alone.
Parent / Guardian Questionnaire
Parent / Guardian Questionnaire
Guidance:
Use this form to lead a conversation with the parents or guardians. Ideally, an administrator or school counselor will lead the conversation.
Note the responses as accurately as possible on the fillable form.
NEVER: Hand the interview to the parent/guardian and ask them to complete it alone.
*a Spanish version can be downloaded below.
School Staff Questionnaire
School Staff Questionnaire
Guidance:
Use this form if teachers / staff are unable to attend the Level 1 meeting. Either, go through the questions with them, noting their responses OR give them the form so they can complete it and return it to you. Their responses should be shared with the entire Level 1 team.
Optional Tools
Optional Tools
Student Witness Questionnaire
Student Witness Questionnaire
Parent Questionnaire (Espanol)
Parent Questionnaire (Espanol)
(K-5) Student Questionnaire
(K-5) Student Questionnaire
Guidance:
Use this form to interview students who directly participated in, or were targeted/victimized by the threatening event.
Ideally, an administrator or school counselor will lead the conversation.
Note the student's responses as accurately as possible on the fillable form.
NEVER: Hand the interview to the student and ask them to complete it alone.
Guidance:
Spanish version of parent/guardian interview.
Guidance:
These questions are designed for students in grades K-5. For very young students, a parent or guardian may be included in the interview.
Ideally, an administrator or school counselor will lead the conversation.
Note the responses as accurately as possible on the fillable form.
NEVER: Hand the interview to the student and ask them to complete it alone.
Guidance:
If after an investigation and professional discussion, the allegation is unfounded or not a threat, complete this form form and maintain for your records.
Salem Keizer Systems Guide
Flowchart
Notification Letter Example
Notification Log
Plan to Protect
Safety Plan
In need of training or a refresher? Our threat assessment training is always free.
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