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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the student's ID number, grade, and school name at the top of the form. This information is crucial for identifying the student involved.
  3. Fill in the date and time of the incident. Accurate timestamps are essential for documentation purposes.
  4. Select the type of intervention used by checking either 'Seclusion' or 'Physical Intervention'. Be sure to indicate the length of time for each intervention.
  5. Provide a detailed description of the location where seclusion occurred, including ventilation, lighting, and room size.
  6. List names and positions of staff who observed the behavior that led to the intervention. This ensures accountability and clarity.
  7. Document any behaviors exhibited by the student prior to intervention. This section should capture emergency situations that necessitated action.
  8. Outline strategies and interventions attempted before resorting to seclusion or physical intervention, noting their outcomes.
  9. Describe the type of restraint used during the intervention clearly and thoroughly.
  10. Record the student's behavior or reaction during restraint or seclusion to provide insight into their experience.
  11. Indicate any reported injuries following evaluation by a health professional, ensuring all incidents are documented.
  12. Complete notification sections regarding communication with parents and other relevant staff members post-intervention.
  13. Finally, ensure that printed names and signatures of all involved staff members are included at the bottom of the form for verification purposes.

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