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Department of Premier and Cabinet

Protocol Template

Name of Organisation

Organisation’s Logo

Protocol Template

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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