Printable worksheets: complete text companions

All prompts from the expanded school, first responder and hospital worksheets. These pages can be read with a screen reader, enlarged in your browser, or printed. Blank writing space appears beneath each prompt when printed.

School and home

Download the 8 page PDF

Home to school: yesterday

Part 1 of 2. Describe what you noticed and what helped.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Completed by: Space to write on the printable sheet.
How did my child seem when arriving home?: Space to write on the printable sheet.
What did my child communicate about school, in any form?: Space to write on the printable sheet.
Mood, comfort and feelings after school: Space to write on the printable sheet.
Evening activities, interests and happy moments: Space to write on the printable sheet.

Home to school: this morning

Part 2 of 2. Share useful context for a supported start.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Sensory needs or concerns last night and what helped: Space to write on the printable sheet.
Sleep: time asleep, waking and quality: Space to write on the printable sheet.
Mood on waking and help needed: Space to write on the printable sheet.
Breakfast, appetite and food still needed: Space to write on the printable sheet.
Important reminders, changes or insights for staff: Space to write on the printable sheet.

School to home: my day

Part 1 of 4. Include my joys as well as the support I needed.

Child’s name: Space to write on the printable sheet.
Grade: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Completed by: staff / caregiver: Space to write on the printable sheet.
Homeroom teacher, if applicable: Space to write on the printable sheet.
Mood on arrival and support offered: Space to write on the printable sheet.
Snack / lunch: hunger, appetite and foods eaten: Space to write on the printable sheet.
Difficult moments: what happened, feelings and support offered: Space to write on the printable sheet.
Wonderful or joyful moments: Space to write on the printable sheet.

School to home: learning and care

Part 2 of 4. Record observations and the support provided.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Activities or subjects today: Space to write on the printable sheet.
IEP goals worked on and support provided: Space to write on the printable sheet.
Hygiene: hand, face and tooth care, toileting and help provided: Space to write on the printable sheet.
Wet pull-ups: change times and number changed: Space to write on the printable sheet.

School to home: care and connection

Part 3 of 4. Notice participation, interests and what made connection possible.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Bowel movements: time, care and changes from usual: Space to write on the printable sheet.
Pull-ups used today and supplies needed: Space to write on the printable sheet.
Peer interaction: connection, play, sharing and teamwork: Space to write on the printable sheet.
Special subjects: art, music, PE or other activities: Space to write on the printable sheet.
Additional comments, concerns and insights for home: Space to write on the printable sheet.

Caregiver handoff

Part 4 of 4. Speak directly with the next responsible adult. A saved log is not a confirmed handoff.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Outgoing caregiver: Space to write on the printable sheet.
Incoming caregiver / responsible adult: Space to write on the printable sheet.
Handoff date and time: Space to write on the printable sheet.
Last pull-up change and next change due: Space to write on the printable sheet.
Changes, safety concerns, supplies and supports to pass on: Space to write on the printable sheet.
Who confirmed receiving the information, when, and follow-up needed: Space to write on the printable sheet.

IEP information and important dates

Keep names, contact details and the current plan together.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
IEP date: Space to write on the printable sheet.
Next review date: Space to write on the printable sheet.
Team member 1: name and role: Space to write on the printable sheet.
Email / agreed contact: Space to write on the printable sheet.
Team member 2: name and role: Space to write on the printable sheet.
Email / agreed contact: Space to write on the printable sheet.
Team member 3: name and role: Space to write on the printable sheet.
Email / agreed contact: Space to write on the printable sheet.
Team member 4: name and role: Space to write on the printable sheet.
Email / agreed contact: Space to write on the printable sheet.
Team member 5: name and role: Space to write on the printable sheet.
Email / agreed contact: Space to write on the printable sheet.
Important dates, meetings and follow-up: Space to write on the printable sheet.

Therapy communication

A reusable session record. Print another sheet for the next session.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Type of therapy: Space to write on the printable sheet.
Therapist / provider name and agreed contact: Space to write on the printable sheet.
Session summary: activities, participation and strengths: Space to write on the printable sheet.
Supports that helped and communication noticed: Space to write on the printable sheet.
Follow-up, home practice agreed with the provider, or next visit: Space to write on the printable sheet.

First responder support

Download the 6 page PDF

Emergency profile: identity

Part 1 of 3. Completed by a parent or legal caregiver. Keep current.

Child’s full name: Space to write on the printable sheet.
Nickname / name used: Space to write on the printable sheet.
Date of birth / age: Space to write on the printable sheet.
Approximate height / weight: Space to write on the printable sheet.
Home address: Space to write on the printable sheet.
Parent / caregiver names: Space to write on the printable sheet.
Primary and secondary phone: Space to write on the printable sheet.
Languages understood or used: Space to write on the printable sheet.

Emergency profile: communication

Part 2 of 3. Describe the child’s own communication and comfort cues.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Communication: speech, some words, nonverbal, device, pictures, gestures or no response: Space to write on the printable sheet.
Helpful words, pictures, songs, videos or sounds: Space to write on the printable sheet.
Touch preferences and how to approach: Space to write on the printable sheet.
Sensory triggers and calming interests: Space to write on the printable sheet.
Medical needs, allergies, pain communication, pica or ingestion risks: Space to write on the printable sheet.

Emergency profile: locating and safety

Part 3 of 3. Update when abilities, attractions or routines change.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Likely destinations or things the child may be drawn to: Space to write on the printable sheet.
Hiding places, return locations and previous places found: Space to write on the printable sheet.
Running, hiding, freezing or interpreting pursuit as play: Space to write on the printable sheet.
Locating device / identification and school or program contact: Space to write on the printable sheet.
Last updated: Space to write on the printable sheet.
Completed by: Space to write on the printable sheet.

Responder encounter: observations

Part 1 of 2. Record observable facts. Follow agency reporting and privacy requirements.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Date / time: Space to write on the printable sheet.
Agency / unit / responder contact: Space to write on the printable sheet.
Location where the child was found: Space to write on the printable sheet.
Environmental conditions and immediate hazards: Space to write on the printable sheet.
Observed when located: movement, hiding, freezing, distress, laughter, response or touch avoidance: Space to write on the printable sheet.
Approach, words, visuals, objects or people that helped: Space to write on the printable sheet.

Responder encounter: care and reunion

Part 2 of 2. Record care, reunification and follow-up information.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Possible injury, exposure, pain, ingestion or other medical concern: Space to write on the printable sheet.
Medical assessment or transport information, if applicable: Space to write on the printable sheet.
Person the child was released or reunited to and verification: Space to write on the printable sheet.
Recommended follow-up and information given to the family: Space to write on the printable sheet.

Family to responder: safety update

Use after an incident or when the child’s abilities, routines or supports change.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
What changed? Exit skills, attractions, routes, communication, health, sensory response, photo or ID: Space to write on the printable sheet.
Describe the change and what responders should know now: Space to write on the printable sheet.
New likely locations or hazards: Space to write on the printable sheet.
New words, visuals, people or objects that may help: Space to write on the printable sheet.
Parent / caregiver contact and date of update: Space to write on the printable sheet.

Hospital support

Download the 6 page PDF

Hospital snapshot: communication

Part 1 of 2. Caregiver information supports clinical assessment; it does not replace it.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Date of birth / age: Space to write on the printable sheet.
Approximate height / weight: Space to write on the printable sheet.
Communication methods and supports: Space to write on the printable sheet.
My yes looks like: Space to write on the printable sheet.
My no / stop looks like: Space to write on the printable sheet.
My pain or illness may look like: Space to write on the printable sheet.

Hospital snapshot: comfort and care

Part 2 of 2. Staff should verify clinical details in the hospital record.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Usual behavior and movement: Space to write on the printable sheet.
Safety needs: elopement, pica or other risks: Space to write on the printable sheet.
Touch or positioning that helps: Space to write on the printable sheet.
Sensory needs and comfort items, words or people: Space to write on the printable sheet.
Important caregiver update today and caregiver name / phone: Space to write on the printable sheet.

Safety and support profile

Part 1 of 2. Verify allergies, medicines, conditions and emergency plans with clinical staff.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Elopement risk: yes / no / unknown. Support needed: Space to write on the printable sheet.
Pica or mouthing risk: yes / no / unknown. Support needed: Space to write on the printable sheet.
Seizure plan: yes / no / unknown. Where staff can find it: Space to write on the printable sheet.
Allergies and where to verify the current record: Space to write on the printable sheet.
Medications / conditions and where to verify current orders: Space to write on the printable sheet.

Support that makes a difference

Part 2 of 2. Ask the person and their caregiver what helps today.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
What helps me: Space to write on the printable sheet.
What makes things harder: Space to write on the printable sheet.
Do not offer without asking: Space to write on the printable sheet.
Comfort items and familiar supports: Space to write on the printable sheet.
Primary support person and contact: Space to write on the printable sheet.

What happened today?

Record what is known. Separate observations from anything uncertain.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Date / time: Space to write on the printable sheet.
Who witnessed it: Space to write on the printable sheet.
What happened: Space to write on the printable sheet.
Possible object / substance and amount, size or material, if known: Space to write on the printable sheet.
Symptoms or changes: Space to write on the printable sheet.
Instructions received from Poison Control / EMS, with time and source: Space to write on the printable sheet.

What worked today?

Help the next visit begin with what was learned today.

Child / student name: Space to write on the printable sheet.
Date: Space to write on the printable sheet.
Successful words or visuals: Space to write on the printable sheet.
Successful positioning: Space to write on the printable sheet.
Successful people / roles and equipment tolerated: Space to write on the printable sheet.
Sensory changes that helped: Space to write on the printable sheet.
What increased distress and what to try first next time: Space to write on the printable sheet.