Get Individual Student Safety Plan 2009-2026

The Individual Student Safety Plan serves as a crucial tool designed to address specific behaviors that may pose risks to the student or others. This guide will provide you with clear and supportive instructions on how to complete the form online.

Follow the steps to complete the Individual Student Safety Plan effectively.

1. Press the ‘Get Form’ button to access the Individual Student Safety Plan, allowing you to open it in the online editor.
2. Begin by entering the student's name. Ensure that the student’s name is spelled correctly to avoid any confusion.
3. Indicate whether the student is enrolled in special education or has a 504 Plan by selecting 'Yes' or 'No' as applicable.
4. Fill in the student’s date of birth (D.O.B.) for proper identification.
5. Input the eSIS number associated with the student, if available.
6. Provide the student's grade level at the time of filling out the safety plan.
7. Complete the contact information section by listing the name of the parent or guardian, their cell phone number, home phone number, and any additional emergency contact details.
8. Outline potential locations where the student may be found if they go missing during school hours. Specify both on and off school grounds.
9. Provide relevant medical information including the name of the student's physician, any diagnoses, medications they may be taking, and details of any allergies or special considerations.
10. Document a description of the specific unsafe behaviors that necessitate the creation of a safety plan.
11. Formulate a crisis response plan detailing immediate actions to take if the student displays the unsafe behaviors previously described.
12. Identify staff members who will be responsible for implementing the safety plan, including backup personnel.
13. List warning signs or triggers that may indicate the potential for unsafe behaviors.
14. Detail strategies that have been successful in supporting the student.
15. State what strategies have not been effective and should be avoided.
16. Discuss the collaborative actions that staff, the student, and their family will undertake to reduce the risk of unsafe behavior.
17. Designate a backup person for monitoring the safety plan’s efficacy.
18. Determine the criteria for concluding the safety plan and identify the relevant personnel involved in this decision.
19. List current agencies or outside professionals who are involved with the student, along with their contact details.
20. Identify members of the Student Safety Team by entering their names and obtaining signatures.
21. Set a review date for the safety plan, typically around two weeks from the plan's initiation or last review.
22. Once all sections are completed, save your changes. You can also download, print, or share the completed Individual Student Safety Plan as needed.

Start filling out the Individual Student Safety Plan online today to ensure safety and support for the student.