Get Burn Injury Report On-line Form - Minnesota Department Of ... - Dps Mn

Filling out the Burn Injury Report On-Line Form is essential for documenting burn injuries as required by Minnesota law. This guide will provide you with step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the Burn Injury Report On-Line Form.

1. Click ‘Get Form’ button to access the form and open it for editing.
2. Fill out the personal information section, including the sex of the individual injured, the nearest city or town where the injury occurred, and the county and state, which should be pre-filled as MN.
3. Enter the date and time of the injury. Be precise to ensure accurate documentation.
4. Provide the medical record number associated with the patient's treatment.
5. Indicate the percentage of body burned by degree of burn. Choose from the options provided for 1st, 2nd, and 3rd-degree burns.
6. Select the areas of the body that have been burned by marking the corresponding checkboxes such as face, arms, legs, or other specified areas.
7. Describe the disposition of the patient following the injury.
8. If the patient was transferred, fill in the name and location of the receiving hospital.
9. Select the location or activity at the time of the burn injury from the provided options and describe if necessary.
10. Choose the cause of the burn injury from the options listed and provide additional details where prompted.
11. Fill out the reporting facility name, address, city, and zip. Include the attending physician's name and any details about the reporting person.
12. Once all sections are completed, review your entries for accuracy. You can save your changes, download, print, or share the form as needed.

Complete your Burn Injury Report online today to ensure proper documentation and compliance.