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Restraint documentation form

Restraint documentation form 2026

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The document is a Seclusion and Restraint Documentation Form from the Michigan Department of Education, outlining the requirements for documenting incidents of seclusion and restraint in public schools. It emphasizes that such practices are generally prohibited except in emergencies, and mandates detailed recording of each incident, including student information, problem behavior, prior interventions, the nature of the intervention used, and follow-up actions taken.

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Click ‘Get Form’ to open the restraint documentation form in the editor.
Begin by entering your name and title in the designated fields, along with the date of completion.
Fill in the student information section, including the student's name, school building, and any known medical conditions. If applicable, provide a brief description of the condition.
Document the problem behavior by noting the date it occurred and describing any antecedents or triggers that led to the behavior.
Detail the behavior itself, including its frequency and intensity, and explain how it posed an imminent risk to safety.
Record prior interventions attempted before seclusion or restraint was used, including their duration.
Indicate whether seclusion or restraint was used, along with details such as start time, staff involved, location of intervention, and a description of what was done.
Note the length of time for both seclusion and restraint. If extended time was necessary, provide justification for this extension.
Describe the student's response to the intervention and document any injuries sustained during this process.
Complete follow-up details with the student after intervention and record contact with parent/guardian regarding reporting.

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