Ambulance De-Rostering Submission Form
We have had numerous reports of crews being de-rostered at end of shift, prior to arriving back at station. This is a health and safety concern that we are trying to address with our CACC management. If you are de-rostered prior to arriving station, please notify your Superintendent and fill out this form as we are tracking all incidents.


1) Please fill as many details in as possible
2) Please book into station at all times with verbal over air and by pressing the 10-7 button.

Thank you for taking the time to submit!

In Solidarity,
TPS Health and Safety

Name: *
Your answer
Email: *
Your answer
Phone Number:
Your answer
Quadrant: *
Station Assigned for De-rostering Incident: *
Your answer
Colour Code:
Your answer
Vehicle Number: *
Your answer
Date *
Approximate Time of De-Rostering *
Location of De-Rostering *
Your answer
Did you book into station on arrival? *
Superintendent Notified *
Additional Information:
Your answer
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