RtI Tools & Forms

Forms listed below are designed to help schools analyze RtI-specific data, track degree of RtI implementation, and organize their RtI process into a school or district plan. Some data forms include webcasts that more fully describe how to complete each form.

RtI Survey Tools

This document is an appendix to the Abridged and Unabridged RTI Survey tools.

NYS RTI/MTSS Self-Assessment Survey for Middle School (Unabridged Version)

New York State Response to Intervention MS Demonstration Project

This survey was developed to examine your school's current RtI/MTSS practices.  You may need to download the "glossary of terms" document as an appendix.

This survey was developed to examine a school's current RtI/MTSS practices.  You may need to download the "glossary of terms" document as an appendix.

The New York State Self-Assessment Tool for RtI Readiness and Implementation was developed by consortium members of the NYS Response to Intervention Middle School Demonstration Project (NYS RtI MS DP) in collaboration with personnel from the New York State Education Department P-12, Office of Special Education. As a self-assessment tool, it is intended to:(1) assist individual schools/districts in evaluating their current level of RtI readiness and implementation and 2) formulate a RtI Implementation plan that will address RtI indicators that require improvement or development. It offers an opportunity for the school community to engage in reflective conversations around the topic of RtI.

This version is the updated version (2019) of the tool developed in 2013.

This document is designed for use in elementary schools.  For the Middle School version, please see the appropriate versions (unabridged and abridged).

This tool is intended for use by a school’s or a district’s RtI Design Team for the purposes of:
1. summarizing and analyzing the results from the NYS Self-Assessment Tool for RtI Readiness and Implementation
2. prioritizing RtI elements or features in terms of importance or priority
3. using results to construct an implementation plan that will guide the RtI process in their respective schools/districts

Sign Up For
Website Updates