Minor Patient Treatment Submission
This form is for very minor treatments like plasters and ice packs. ANY physical assessment or treatment must be documented on a full form.
Nexus Event #ID
*
4 digit number found on the event briefing sheet.
Patient Gender
*
Please Select
Male
Female
Presenting Complaint
*
i.e - Head Injury, Arm wound, Sprained Ankle
Treatment Completed
*
Very Brief Summary (i.e - Ice pack applied)
Disposition
*
Please Select
Treated & Discharged
Treated & Self Conveyed
Conveyed
Location Of Incident at Event
*
i.e - Main arena, Floor 1, Pitch 2 etc
Without Nexus intervention would this patient require NHS intervention?
*
Please Select
YES
NO
For example - wound closure, antibiotics, ambulance conveyance etc.
Nexus Staff Member Name
*
Submit
Should be Empty: