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THE CITY OF PEORIA PREMEDICAL DEPARTMENTREQUEST FOR EMS INCIDENT REPORT Request for Public Records (A.R.S. Title 39) If the requester is not the patient or patients guardian, then HIPAA-compliant
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How to fill out medical incident
How to fill out medical incident
01
Gather all necessary information such as patient's personal details, medical history, and contact information.
02
Begin by documenting the date and time of the incident.
03
Describe the nature of the incident and the symptoms experienced by the patient.
04
Provide a detailed account of any treatments or procedures administered.
05
Include any witness statements or observations regarding the incident.
06
Document any follow-up actions taken or recommendations given to the patient.
07
Make sure to sign and date the incident report.
Who needs medical incident?
01
Medical incidents need to be filled out by healthcare professionals, including doctors, nurses, and other medical staff.
02
In certain cases, patients or their guardians may need to fill out an incident report if it involves their personal experience or negligence.
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