Medical Incident Reporting Form - Rescue Fire Company 37 2026

1. Click ‘Get Form’ to open the Medical Incident Reporting Form in the editor.
2. Begin by entering the patient's name, age, date of birth, and address in the designated fields. This information is crucial for identifying the patient.
3. Select the gender of the patient and describe their chief complaint clearly in the provided section.
4. Assess and document the initial level of consciousness by selecting from options such as Alert or Verbal.
5. Record vital signs at three different times. Fill in pulse, respirations, and blood pressure readings accurately for each time slot.
6. Utilize the Glasgow Coma Scale to evaluate eye, verbal, and motor responses. Input scores accordingly.
7. Indicate lung sounds and any signs & symptoms observed. Document past medical history, medications, and allergies in their respective sections.
8. Complete the narrative section with detailed observations and care provided. If more space is needed, continue on the next page.
9. Fill out details for emergency care providers involved in treatment, including names and certification numbers.
10. Finally, ensure that you sign as the primary provider and note the contact date & time before submitting your form.

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