FIFA World Cup EMS Site Recap

Health & MEdical Branch
EMS Operations Center

Site Recaps for assigned EMS Units

* Indicates required field

Date & Times for this report *

Agency *

Unit ID# *

Site/Location *

Type of Coverage *

Level of Coverage *

Name *

First

Last

Phone Number *

Submitted by Email *

TOTAL EMS Contacts *

# High Acuity *

# Medium Acuity *

# Low Acuity *

BLS Transport *

ALS Transport *

Treat/Release *

RMA / AMA *

Unfounded / Cancelled *

Contact the NJ EMS Operations Center at 973-878-9911 or email [email protected] if any questions on completion of this report.

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