End of Shift Report
EMS
Date
*
/
Month
/
Day
Year
Date Picker Icon
Crew Member 1
*
First Name
Last Name
Crew Member 2
*
First Name
Last Name
Division
Augusta
Thomson
Aiken
North Augusta
Rock Hill
Choose appropriate division
Shift supervisor
*
Matt Finnegan
Joel Hughes
Teresa Griswell
Please select one
Unit Number
*
Number of Calls Ran
*
Refueled (Above 3/4)
*
Yes
No
Mileage
*
Truck Washed/Cleaned
*
Yes
No
Why truck not washed.
*
Trashed Emptied?
*
Yes
No
Pt compartment/cab cleaned?
*
Yes
No
If compartment/cab not cleaned, Explain.
*
Paperwork Corrected?
Yes
No
Damage to unit?
*
Yes
No
If yes to damage explain
*
IV box, Drug Box, AED, Cardiac Monitor returned to pyxis.
*
Yes
No
Monitor batteries returned to charger.
*
Yes
No
Paperwork completed and posted?
*
Yes
No
If no to Paperwork complete, Explain.
*
Shop requests for unit
*
Yes
No
Supplies Used
*
Station Chores Completed
*
Comments
Crew Member 1Signature
*
Crew Member 2 Signature
*
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