Patient Information & Tracking Form

SKU: #IC3005

Duplicate form for recording patient assessment, medical care, and transportation information for an evacuation, from initial assessment to point of departure.

PRICE:
$24.95

Description

The Patient Information & Tracking Form records vital information from initial assessment to the point of departure. The form includes critical patient care information such as allergies, primary diagnosis and relevant co-morbidities, and level of consciousness as well as transportation information such as means of transport, accepting facility, and last actions prior to departure. The top copy leaves with the patient and the bottom copy remains for medical records.

Available As

  • Patient Information & Tracking Form (IC3005)

Specifications

Patient Information & Tracking Form (IC3005)

  • Each form has one yellow duplicate copy

Contents

  • Pack of 25 forms