1001 / JOHN SMITH FILE

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SPECIAL NEEDS EMERGENCY SAFETY FILE

FILE# 1001

NAME - JOHN SMITH

DATE OF BIRTH - 01-06-2000

HOME ADDRESS - 123 MAIN STREET / FAMILY TOWN / MI 12345

EMERGENCY CONTACTS

DAD - STEVE SMITH - 202-111----

MOM - SUSAN SMITH - 202-111----

PRIMARY DOCTOR - DR GREEN - 202-123----

COUNTY CASE WORKER - BOB OCONNOR - 202-123----

SPECIAL NEEDS SPECIFICS

*EXTREME AUTISM & EPILEPSY

*NON-VERBAL / DOESN’T SPEAK AT ALL

*DOESN’T UNDERSTAND DANGER OR DIRECTIONS

*THINK ADULT NEWBORN

*GETS AGITATED EASILY / DOESN’T LIKE TO WAIT

*CAN BECOME SLIGHTLY COMBATIVE

*HAS TO BE CONSTANTLY MOVING

*IS ON SEVERAL MEDICATIONS & MUST BE TAKEN

AT SPECIFIC TIMES. SEE MEDICATION INFO CARD AT HOME

*LIKES YOUTUBE - BARNEY AND BLUES CLUES VIDEOS

*LIKES PIZZA, MAC & CHEESE, GOLDFISH CRACKERS, FRENCH FRIES,

JUICE BOXES, AND CHOCOLATE CHIP COOKIES

LAST SEIZURE WAS 12/10/2021 / COMES OUT OF NO WHERE

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