This form is used to submit any concerns, damage reports, or maintenance needs for LCVRS owned apparatus including on-board radios, MDT, and cot restraint / PowerLoad systems. For concerns about removable equipment including the patient care Toughbook, actual cot, portable radios, etc., please email
Pictures or other supporting documentation can be emailed to
Which apparatus is this report for?
Reserve Boat 613
Is the issue the result of an accident?
Is the unit currently in service?
Please describe the problem, issue, or concern below:
Send me a copy of my responses.
Never submit passwords through Google Forms.
This form was created inside of Lcvrs.org.
Terms of Service