Templates: Media agreements, plans, and reflections

Family Agreements

Common Sense Media – Family Media Agreement (PDF)

• Covers device care, safety, balance, kindness, and communication

• Designed to be completed together by students and caregivers

Just Old Enough – Family Media Agreement

• Includes screen time limits by purpose

• Emphasizes balance, respect, and open conversations

SmartSocial – Family Media Agreement (Editable Google Doc)

• Includes versions for different ages

• Available in English and Spanish

After‑School Tech Plans (Student + Caregiver)

Healthy Screen Habits – Family Technology Plan

• Helps families decide when, where, and why technology is used

• Strong emphasis on routines and balance

Screen Time Reflection Sheet (Student + Caregiver)

Teaching Channel – Screen Time Self‑Audit

• Helps students reflect on how screens affect mood, focus, and sleep

• Excellent fit for advisory, counseling, or home reflection

We Are Teachers – Screen Time Tracker

• Daily/weekly tracking versions

• Easy for families to complete together