Follow the steps to fill out the template effectively.

1. Click the ‘Get Form’ button to obtain the template and open it for editing.
2. Start by filling in the date of the incident and the location where it occurred. Be sure to provide the name of the department involved, as well as the client's name.
3. List the names of all staff involved in the intervention, ensuring to include the team leader's name first.
4. Indicate who completed the log by entering that person's name in the designated field.
5. Provide a brief description of the location and any activities that were happening prior to the incident, including any anxiety-related behaviors displayed by the client.
6. Mark the levels exhibited from the CPI Verbal Escalation ContinuumSM by checking the relevant boxes. You may also specify any other relevant behaviors.
7. Describe the behavior exhibited by the client during the incident, detailing any verbal or physical challenges.
8. Outline the staff's response or intervention by selecting the appropriate options provided. You may specify additional responses in the provided spaces.
9. Summarize the limits that were set during the intervention, and check whether they were clear, reasonable, enforceable, and effective.
10. Indicate the results of the intervention by marking the relevant boxes to reflect changes in behavior before and after the intervention.
11. If applicable, continue detailing any physical behavior exhibited by the client, including descriptions of any self-abusive or aggressive actions.
12. Complete the staff response to physical behaviors section by documenting the actions taken during such incidents.
13. Once all sections are completed, you can save your changes, download the document, print it, or share it as needed.

Begin completing the Individual Data Collection Template - CPI online today to ensure accurate incident documentation.