EMT Log
Please complete after every ambulance run
EMT Name
*
First Name
Last Name
Unit
*
Please Select
B2
B1
Date & Time completed
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Patient Care Area
Rear of the ambulance
Call Log
Type of call
*
911
Transport
Please confirm that you have received the following documents for the Transport call ( and remember to upload them in your PCR)
Crew Log
Crew Debrief completed
*
Yes
No
Please rate the crew performance on this call.
*
Rows
Name
Performance rating
Comments
Driver
3 - Exceeds Expectations: Performed above expected levels. Acted as a major catalyst for team success
2 - Meets Expectations: Competent and reliable. Completed all key tasks consistently.
1 - Needs Improvement: Required significant coaching to complete assigned tasks.
Rider 1
3 - Exceeds Expectations: Performed above expected levels. Acted as a major catalyst for team success
2 - Meets Expectations: Competent and reliable. Completed all key tasks consistently.
1 - Needs Improvement: Required significant coaching to complete assigned tasks.
Rider 2
3 - Exceeds Expectations: Performed above expected levels. Acted as a major catalyst for team success
2 - Meets Expectations: Competent and reliable. Completed all key tasks consistently.
1 - Needs Improvement: Required significant coaching to complete assigned tasks.
Crewshoutouts/Outstanding perfromance
Any Training/ Refresher training Recommendations:
Issues to report
Communication issues
Coordination issues
Equipment issues
Print
Submit Log
Should be Empty: