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GEMS Online Patient Log
Please make an entry for every patient seen at your event, including basic first aid requests.
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* Indicates required question
Patient Disposition
*
First Aid Only (Only complete online log)
Release On Scene (PCR must be completed for patient)
Against Medical Advice (PCR and AMA must be completed for patient)
AMA by Other EMS Agency (PCR must be completed for patient)
Ambulance Transport (PCR must be completed for patient)
On Site Clinic (Only complete online log)
Other - must attach supporting documentation
Event Name
*
Your answer
Date Patient was seen
*
MM
/
DD
/
YYYY
Time the patient was seen
*
Time
:
AM
PM
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