Health ServicesSeizure RecordEffective: 7-01, 4/03, 5/04, 1/08 SEIZURE RECORDSTUDENT’S NAME DATE CLASSROOM TIME OF OCCURRENCE PRECEDING CONDITIONS: Student’s Location Student’s ActivityWarning Signs No Yes If “Yes” describe SEIZURE BEHAVIOR:Duration (if approximate, state it) Did student’s body stiffen? No Yes Any apparent injury? Did student appear to become unaware of the environment? - - - - - - - - - -- - - - - - - - - - - - - - Urine No Yes Feces No Yes Did student have difficulty breathing?
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Everett Public Schools Documents 
