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Public Swimming Pool Accident Drowning Report Mobile App

The Public Swimming Pool Accident Drowning Report mobile app must be completed for every physician- treated accident or any drowning at a public swimming pool. It is the responsibility of the pool operator to submit the completed form promptly.

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

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Take a peek inside the Public Swimming Pool Accident Drowning Report Mobile App

Included Features

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Included Fields

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

  • Ico statictext

    This report must be completed for every physician- treated accident or any drowning at a public s...

  • Ico date

    Date of Incident

  • Ico time

    Time:

  • Ico textbox

    First Name

  • Ico textbox

    MI

  • Ico textbox

    Last Name

  • Ico textbox

    Address

  • Ico textbox

    City or Town

  • Ico textbox

    State

  • Ico integer

    Zip Code

  • Ico dropdown

    SEX

  • Ico integer

    Age of Victim:(yrs)

  • Ico checkbox

    Non-Fatal

  • Ico checkbox

    Fatal

  • Ico dropdown

    Non-Swimmer:

  • Ico statictext

    Area of the Body Injured: (Check all that Apply)

  • Ico checkbox

    Head

  • Ico checkbox

    Arm / Hand / Finger

  • Ico checkbox

    Trunk

  • Ico checkbox

    Leg / Foot / Toe

  • Ico textbox

    Other (Specify)

  • Ico statictext

    Type of Injury: (Check all that Apply)

  • Ico checkbox

    Abrasion or Contusion

  • Ico checkbox

    Concussion

  • Ico checkbox

    Strain or Sprain

  • Ico checkbox

    Fracture

  • Ico checkbox

    Laceration

  • Ico textbox

    Other (Specify)

  • ...and More!

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