First Aid Form

First Aid Form (WCS)

Injury/Illness
Person Information

Impacted by injury or illness
Report In
Incident Type
RISK DESCRIPTOR
Urgent Serious Risk - Immediate Action
Someone was hurt, or there is still a very high chance of someone getting badly hurt as the situation hasn’t been resolved. First Aid/Police/Ambulance/ Hospital required.
Level of Alert
Name of Participant

First NameLast Name
Date of Injury/Illness

DayMonthYear
Date
Time

:HourMinutesAM/PM Option
Where the situation occurred - location
Current Medications (as per Monday.com)
Allergies (if known)
First Aider

First NameLast Name
Email of First Aider
example@example.com
Position
Site
What happened?
What happened leading up to the injury/illness?
Who first identified the problem/what did they observe?
What happened?

Complete observations

Rows	Obs 1	Time of Obs 1	Obs 2	Time of Obs 2	Obs 3	Tine of Obs 3
Pulse Rate per min Regular/Irregular
Breathing Rate, Depth, Noises
Conscious State Responds to: voice/touch/pain
Skin Colour normal/pale/flushed
Skin Temperature hot/warm/cold
Skin Moisture dry/moist

First Aid Form (WCS)