Restraint form 2026

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The document is a Physical Restraint Documentation Form used by schools to record incidents involving the physical restraint of a student. It includes sections for detailing the child's information, incident specifics, behaviors leading to restraint, de-escalation efforts, descriptions of the restraint and subsequent actions, any injuries sustained, future alternatives to restraint, and notifications to parents and site administrators. The form also captures findings from debriefing meetings and allows for signatures from involved personnel.

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Click ‘Get Form’ to open the restraint form in the editor.
Begin by entering the child's name, student ID, birthdate, grade, and age in the designated fields. This information is crucial for identifying the student involved.
Fill in the parent(s) details including their names and contact numbers. Ensure accuracy for effective communication.
Document the date and location of the incident along with the beginning and ending times. This helps establish a clear timeline.
Describe the student's behavior leading up to the incident. Provide detailed observations to give context to the situation.
Outline any de-escalation efforts made prior to using physical restraint. This section is vital for understanding alternative strategies employed.
Detail the physical restraint used, including descriptions of actions taken by both student and personnel during this time.
After completing all sections, review your entries for accuracy before signing off on the document.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a form of restraint?

Restraint includes chemical, mechanical and physical forms of control, coercion and enforced isolation, which may also be called restrictive interventions.

What are 5 examples of restraint?

Some examples of physical restraints include: Lap belts. Recliners that lean back, preventing easy movement. Side rails. Concave mattresses that prevent the patient from getting out of bed. Vests or belts on the wrists, pelvis, or waist that restrict movement. Trays or other devices that can prevent rising from a chair.

What is the restraint method?

Means of restraint are instruments intended to restrain or temporarily limit the freedom of movement of a person without injuring him/her, for example, handcuffs, straps, straitjackets, or restraining beds.

What are the 3 types of restraints?

There are three types of restraints: physical, chemical and environmental. Physical restraints limit a patients movement. Chemical restraints are any form of psychoactive medication used not to treat illness, but to intentionally inhibit a particular behaviour or movement.

How to document restraints?

The flowsheet should include the following: patient behavior that indicates the continued need for restraints patients mental status, including orientation number and type of restraints used and where theyre placed condition of extremities, includ- ing circulation and sensation extremity range of motion