Get Remote Health Medical Evacuation Form Principal Name Other Names Hrn Health Centre Client's Usual

Completing the remote health medical evacuation form is essential for ensuring the safe and efficient transfer of individuals requiring medical evacuation. This guide provides clear, step-by-step instructions to help you fill out the form accurately and thoroughly.

Follow the steps to complete the form with ease.

1. Use the 'Get Form' button to access the remote health medical evacuation form. This action will allow you to open the document in a suitable editor for input.
2. Begin by filling in the principal name field with the individual’s full legal name. Ensure accuracy as this information is critical for identification.
3. Next, enter any other names the person is known by. This could include nicknames or previous names, which helps establish a complete record.
4. Input the health reference number (HRN) that corresponds to this individual's medical records. Confirm this number is correct and current.
5. Provide the name of the health centre where the individual usually receives care. This should reflect their primary medical facility.
6. Fill out the client’s usual address or community. This is necessary for any regional considerations regarding the evacuation.
7. Record the date of birth by entering the day, month, and year in the appropriate format.
8. Specify the phone number and fax number for contact purposes. Ensure these numbers are those currently in use.
9. Indicate the gender of the individual by selecting the appropriate option. Provide details for next of kin, including their relationship, address, and contact number.
10. If applicable, complete the escort section with their relationship to the individual, their address while in town, and a contact number for them.
11. Fill in the names and designations of clinical staff attending to the individual during the evacuation process.
12. Describe the presenting problem or the main reason for the medical evacuation. Be as precise as possible to aid in understanding the medical context.
13. List any relevant medical and surgical history. If you have a personal clinical information summary sheet, indicate that it is attached.
14. Document any allergies or medical alerts that could affect treatment and care during the evacuation.
15. Conduct a clinical examination and record the practitioner’s name, the date, and the time of the examination.
16. Provide observations related to vital signs such as pulse, blood pressure, respiration rate, and temperature. Include any additional notes pertinent to the individual’s health status.
17. Document the details of any treatments, drugs, or fluids administered, including sizes and sites of IV cannulas.
18. Complete the pre-evacuation checklist, ensuring to tick each item that is applicable and completed, and retaining copies of mandatory documents.
19. Before finalizing, review the entire form for accuracy and completeness. Make any necessary adjustments.
20. Save your changes, then choose to download, print, or share the completed form as needed.

Complete your document online to ensure a smooth medical evacuation process.