PCR (Patient Care Report) Short Forms may be found here

3/24/2023

Under the emergency rules, if you need to use a paper report, you must also comply with the requirements.  These form are located in the Policy Manual (Search for D4 in the policy maual).
For now, use these links.  Please do not use any older forms you may have on hand.

NWC EMSS SHORT FORM

Must leave 1 of these at receiving facility:

ePCR or Short-form (see data policy)

If short-form left; have 2 hrs to provide ePCR

 

Official NWC EMS SHORT FORM

Earliest use: 3/20 COVID-19 contingency

Transitioned 1/22 when the first set of emerg rules was posted

FINAL EDITION (3/23) in effect now

May print on NCR paper so 2nd copy is immediately available rather than Xeroxing form for EMS use

 

We must also do a 100% audit every time the Short Form is left.





 
© Copyright 2008 Northwest Community Emergency Services System. All Rights Reserved
Site design and developement by americaneagle.com
NWC EMSS | Northwest Community Hospital | CSM Building, Suite 5400 | 800 W. Central | Arlington Heights, IL 60005