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Name of Organisation | Organisation’s Logo |
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Name of Contact and Agency: | (Add details of name of Contract and Agency) |
Protocol Description: | (Add details of protocol Description) |
Name of Person Protocol relates to: | (Add details of Name of Person Protocol relates to) |
Protocol Date: | (Add Protocol Date) |
List of Related Documentation: | (Add List of Related Documentation) |
Background/Context ie Why is this Restrictive Practice in place? | (Add details of Background/Context ie Why is this Restrictive Practice in place? |
Protocol/Procedure described: (please list) | |
Review Date: | (Add Review Date) |
Protocol Training Schedule for Staff: | (Add details of Protocol Training Schedule for Staff) |
Signature: |
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