Get Mi Seclusion And Restraint Documentation Form 2017-2025

This guide provides clear, step-by-step instructions for filling out the MI Seclusion And Restraint Documentation Form online. Completing this form accurately is essential to document and report the use of seclusion and restraint in Michigan public schools.

Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. In the first section, enter your name as the staff member completing the form. Provide your title and the date on which you are filling out the document.
3. Next, fill in the student information section. Include the student's name and the school building they attend. Indicate whether the student has a known medical condition by selecting 'Yes' or 'No'. If 'Yes', provide a brief description of the medical condition.
4. For the problem behavior section, input the date the behavior occurred. Describe any antecedents or triggers that led to the behavior, along with details about the behavior, including its frequency and intensity. Explain how it posed an imminent risk to safety and state how long the behavior lasted before intervention.
5. In the prior interventions section, describe any strategies or interventions attempted before resorting to seclusion or restraint. Indicate the duration these strategies were attempted.
6. For the intervention section, select whether seclusion or restraint was used. Document the time the intervention began and the staff member who initiated it. Record the names of all involved staff members, marking an asterisk next to those who received comprehensive training.
7. Specify the location of the intervention (e.g., classroom, hallway). Describe the seclusion or restraint method utilized and indicate the length of time each was employed. For seclusion, note if extended time was necessary and explain the reason.
8. Detail the student's response to the intervention and indicate if any injuries were sustained. If injuries occurred, identify who was injured and briefly describe the injury.
9. In the follow-up section, describe the follow-up that occurred with the student after the intervention, including when and where this took place.
10. Document any contact with the parent or guardian, including the date and time. Note whether a written report was provided and, if not, detail the efforts made to ensure the parent received documentation.
11. Once all sections of the form are complete, review the content for accuracy. Save your changes, then download, print, or share the finished form as needed.

Complete your documentation online to ensure compliance and support effective reporting.