The goals of the study were to (a) examine teacher-reported acceptability of a daily report card (DRC) intervention for a student in their classroom prior to and during implementation; (b) examine factors that predict acceptability; and (c) explore the relations between teacher-reported acceptability, student and teacher characteristics prior to implementation, implementation integrity (treatment dose, adherence, and teacher competence), and student outcomes. Participants were 39 elementary school teachers and 39 students with or at risk of attention-deficit hyperactivity disorder (ADHD). Teachers were asked to implement the DRC for up to 16 weeks with consultation support provided by research team staff every other week. Teachers completed acceptability ratings about the DRC prior to and after two months of implementation. This multi-method assessment using correlation and regression analyses revealed that although acceptability ratings prior to implementation were related to teacher knowledge of ADHD, they were was not related to acceptability ratings during implementation, integrity, or student outcomes. Student's initial positive response to the intervention (i.e., the magnitude of improvement in DRC target behaviors) was associated with higher acceptability ratings during the intervention. Greater increases in acceptability over time were associated with greater DRC dose (i.e., teacher compliance to procedures and longer DRC duration). Greater duration of implementation and responding appropriately to rule violations were associated with greater student achievement of DRC goals. Implications for interpreting acceptability ratings and for understanding factors related to implementation and outcomes are discussed. [This is the online version of an article published in "School Mental Health."]