Restraint and Seclusion Incident Report Form

When a restraint or seclusion incident occurs in a special education setting, proper documentation is critical for student safety, staff accountability, legal compliance, and continuous improvement of behavior intervention plans. This restraint and seclusion incident report form provides a structured framework for capturing all essential details immediately following an incident.

Designed specifically for special education programs, therapeutic schools, and support service providers, this template ensures your team documents antecedent behaviors, the specific intervention techniques used, duration of the incident, individuals involved, and the complete debrief process. The form guides staff through recording environmental factors, student responses, and any injuries or medical attention required, creating a comprehensive record that meets regulatory reporting requirements.

With Paperform's conditional logic, the form adapts based on the type of incident reported, revealing relevant follow-up questions for restraint versus seclusion events. This intelligent branching ensures staff complete only applicable sections while maintaining thoroughness. The clean, professional layout makes it easy to complete even in stressful post-incident situations, and the digital format eliminates illegible handwriting that can compromise documentation quality.

Integration capabilities allow you to automatically route completed reports to administrators, behavior specialists, and parents as required by your policies and applicable regulations. Connect to your student information system via Stepper to link incidents with existing behavior intervention plans and trigger review workflows when incidents exceed established thresholds.

This form supports trauma-informed practices by including sections for student debrief, staff reflection, and immediate safety plan adjustments. By standardizing your incident reporting process, you create valuable data for identifying patterns, revising prevention strategies, and demonstrating your program's commitment to using restrictive interventions only as a last resort. Whether you're a special education director, behavior specialist, or program coordinator, this template helps you maintain the detailed records necessary for both compliance and continuous improvement of student support systems.