ZONES OF REGULATION STAFF PRE-QUESTIONNAIRE Date:______

1 2 3 4 5 I believe in the value of implementing the Zones of Regulation to support student learning and outcomes I provide students the opportunity to acknowledge their state of readiness for learning. I provide students the opportunity to take action and ready themselves for learning/participation. I support students who have difficulty with self-regulation (e.g., making transitions, staying on task, etc) by teaching them productive ways to self-regulate in support of learning. I have developed an implementation plan to support my implementation of the zones curriculum and have thought about how I will integrate the concepts throughout the school day. I have dedicated time, and will adapt my school day routines and rituals to ensure I am supporting students in their development of self-regulation (using the zones program and other strategies) I feel supported in implementing this program. I feel ready to implement this program fully and effectively. I understand how the learning from Zones of Regulation will improve my students’ learning and personal growth.

1. Strongly Disagree

2. Somewhat Disagree

3. Neutral

4. Somewhat Agree

5. Strongly Agree