When It Is Used
Use this form at the beginning of FBA work when a concern must be prioritized before definition and data collection.
FBA Referral and Problem Identification Form
FBA Referral / Problem Identification Form is a practitioner-only intake and prioritization tool for functional behavior assessment. It helps practitioners describe a challenging behavior concern, document why it warrants assessment, and select a target narrow enough to guide the next FBA steps.
Complete a fictional referral draft and review whether the target and rationale are sufficient before saving the form.
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Tool guide
Learn more about this tool
Use this background section to understand when the tool fits, how practitioners use it, and what to consider before sharing it with clients.
What It Produces
The result is a prioritized behavior focus and rationale for assessment, not a functional hypothesis or intervention plan.
Readiness Limits
A broad concern, missing rationale, or multiple unprioritized concerns keeps the form in draft or revision status.
Is this a full FBA?
No. It is an intake and prioritization form that identifies the FBA focus and rationale.
Does a client or caregiver complete this?
No. The specified configuration is practitioner-only.
What information is required?
The form requires a behavior concern, rationale for assessment significance, and a selected target behavior.
Does it generate a behavior function?
No. It does not generate functional hypotheses, ABC data, or intervention recommendations.