Student Threat Assessment Protocol Document

Student Threat Assessment Protocol

Confidential Documentation & Intervention Planning

Emergency Protocol: If there is an imminent danger to life or safety, call 911 immediately. This form is for documentation and post-stabilization assessment.

CONFIDENTIAL STUDENT THREAT ASSESSMENT

Do not distribute without administrative authorization.

Date of Report:

I. Incident & Student Information

Student Name

Student ID #

Grade Level

Date of Incident

Reported By

II. Threat Details

Threat Type (Check all that apply)

Verbal Threat Social Media/Online Written/Drawing Physical Gesture Possession of Weapon Threat of Self-Harm

Specific Description of Threat/Incident:

III. Risk Classification (Team Determination)

Select the determined risk level based on the investigation (interview with student, witnesses, parent contact).

LOW RISK
Vague, implausible, no specific target. Threat is transient.

MODERATE RISK
More concrete, feasible, but no immediate preparation taken.

HIGH RISK
Specific target, known means, detailed plan.

IMMINENT
Immediate danger. Active preparation/weapon. Call 911.

IV. Intervention & Management Plan

Disciplinary Actions

Support Services

Parent/Guardian Notification

Law Enforcement Involved?

LE Report Details

V. Assessment Team

Administrator Signature

Date

Recorded Assessments

A session-based log of assessments created today.

Date	Student	ID	Risk Level	Actions

Assessment Team Configuration

Define the standard team members for the PDF signature block.

Administrator / Principal

School Counselor/Psych

School Resource Officer (SRO)

District Safety Lead