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Quarterly Report for Basic Life Support Ambulances Providing Emergency Response Mobile App

The Quarterly Report for Basic Life Support Ambulances Providing Emergency Response mobile app allows you to complete your quarterly report using a mobile device. The app covers: Call Totals, Patient Age / Sex Breakdown, Nature of Call, Procedures and Destinations. Pre Approval is required to use the GoCanvas Logo.

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  • The Cooperative
  • PG&E
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  • Red Bull
  • Mirvac

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Take a peek inside the Quarterly Report for Basic Life Support Ambulances Providing Emergency Response Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    QUARTERLY REPORT FOR BASIC LIFE SUPPORT AMBULANCES PROVIDING EMERGENCY RESPONSE

  • Ico statictext

    Reports are due to Office of Emergency Medical Services by the 30th of April, July, October and J...

  • Ico dropdown

    Reporting Quarter (Check only one)

  • Ico integer

    Year

  • Ico textbox

    Service Name

  • Ico textbox

    Telephone Number

  • Ico multiline

    Address

  • Ico decimal

    BLS Charge Per Call

  • Ico textbox

    Name of Person Completing Report

  • Ico textbox

    Name of EMS Director

  • Ico integer

    Total Dispatches

  • Ico integer

    Calls with Patients

  • Ico integer

    D.

  • Ico integer

    R.

  • Ico integer

    Treat and Transport

  • Ico multiline

    Comments:

  • Ico integer

    0 – 1 Year

  • Ico integer

    2 – 8 Years

  • Ico integer

    9 – 20 Years

  • Ico integer

    21 – 45 Years

  • Ico integer

    46 – 65 Years

  • Ico integer

    66 Years and older

  • Ico integer

    Unknown

  • Ico calculator

    Total for All Ages

  • Ico integer

    Male

  • Ico integer

    Female

  • Ico integer

    Unknown

  • Ico calculator

    Total Patients

  • ...and More!

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