Dispatch Shift Report

Dispatch Shift Report

*This form must be filled out for every shift. 7-3, 3-11, 11-7
(Please include OOS vehicles, employee issues, complaints, etc.)

*Anything that is URGENT must IMMEDIATELY be communicated with a member of management, as well as documented in this report.

Failure to complete this report by the end of your shift could result in disciplinary action, up to and including termination.
Date

MonthDayYear
DateHourMinutes
Dispatcher Name:*

First NameLast Name
Select your shift:*
- YesNo
- Please Explain:
- Please list all employee call outs:
- Please enter incident numbers of calls that are Data Entry Errors (i.e. duplicates) that need to be deleted from AIM.
- YesNo
- OOS Vehicles:
- Comments:
- YesNo
- Please explain:
- YesNo
- Enter Call Number(s):
- YesNo
- Enter Call Number(s):
- YesNo
- Enter Call Number(s):
- YesNo
- Enter Call Number(s):
- YesNo
- Please note them:
- Please enter all medi-van level calls that are denied that are within our service area. Calls that are out of our service area do not need to be entered.
  
  Example for inclusion:
  
  MART calls with a patient needing to go from Gardner to Leominster and we are not able to do it. This needs to be entered here.
- Enter Call Number(s):
- Please note any concerns, you had during your shift.
- Miscellaneous notes, otherwise not categorized.
- Should be Empty: