More examples in Healthcare/Medical Examination Reports
Medical Examination Disaster Checklist Example
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Text in this example:
DISASTER - CHECKLIST (To be completed by the Field Deputy Medical Investigator or first person getting report.) TIME: DATE: NOTIFICATION BY: AGENCY AGENT PHONE: CELL: PAGER: ASK HOW WE GET BACK IN TOUCH WITH NOTIFIER – OTHER MEANS TO CONTACT: INITIAL DISASTER EVALUATION WHAT HAPPENED: LOCATION AND TERRAIN (GET SPECIFICS - GET DIRECTIONS TO ACTUALLY ACCESS THE SCENE): ACCESSIBILITY (HAS SOMEONE BEEN TO THE SCENE; IS IT REACH ABLE – EXPLAIN ANY PROBLEMS ACCESSING SCENE): IS COMMUNICATION AVAILABLE AT SITE (WHAT/BY WHOM/HOW): WEATHER CONDITIONS (CURRENT AND FORECAST): COMMON CARRIER, DESCRIPTION, PLACE OF ORIGIN AND DESTINATION (TELL US AS MUCH AS
POSSIBLE ABOUT THE CARRIER): DO NOT COMMUNICATE THIS INFORMATION ON OPEN AIRWAY LAW ENFORCEMENT AGENCY IN CHARGE OF SCENE (AGENCY/AGENT AND INCLUDE CONTACT
INFORMATION): OTHER AGENCIES INVOLVED (AGENCY/AGENT/CONTACT): INITIAL ASSESSMENT ARE THERE SURVIVOR(S)? YES NO – NUMBER IF KNOWN: HAVE ALL SURVIVOR(S) BEEN REMOVED? YES NO - IF YES, WHERE TO? ESTIMATED NUMBER OF FATALITIES: CONDITION OF FATALITIES (IF KNOWN): DO DANGEROUS OR HAZARDOUS CONDITIONS EXIST THAT MIGHT HAMPER BODY RECOVERY
IMMEDIATELY – EXPLAIN: NAME OF INVESTIGATOR DMI#
POSSIBLE ABOUT THE CARRIER): DO NOT COMMUNICATE THIS INFORMATION ON OPEN AIRWAY LAW ENFORCEMENT AGENCY IN CHARGE OF SCENE (AGENCY/AGENT AND INCLUDE CONTACT
INFORMATION): OTHER AGENCIES INVOLVED (AGENCY/AGENT/CONTACT): INITIAL ASSESSMENT ARE THERE SURVIVOR(S)? YES NO – NUMBER IF KNOWN: HAVE ALL SURVIVOR(S) BEEN REMOVED? YES NO - IF YES, WHERE TO? ESTIMATED NUMBER OF FATALITIES: CONDITION OF FATALITIES (IF KNOWN): DO DANGEROUS OR HAZARDOUS CONDITIONS EXIST THAT MIGHT HAMPER BODY RECOVERY
IMMEDIATELY – EXPLAIN: NAME OF INVESTIGATOR DMI#