2017 Crew Member Evaluation
Remember to fill out this form for BOTH Crew Members on your scene. If there are any problems that need to be immediately addressed, please let Rachel know by phone or email.
Name of Crew Chief
This information will be kept anonymous.
Call Number
Write as 2017-XXX
Your answer
Priority of the Patient
Priority 1 — Critically ill or injured person requiring immediate attention, Priority 2 — Less serious condition yet potentially life-threatening injury or illness, requiring emergency medical attention but not immediately endangering the patient’s life, Priority 3 — Non-emergent condition, requiring medical attention but not on an emergency basis, Priority 4 — Does not require medical attention.
Name of Line Officer
List only if he/she was present on scene.
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms