Get 2-920 Form - California Emergency Management Agency - State Of ... - Calema Ca

The 2-920 Form is a critical document required by the California Office of Emergency Services for reporting suspicious injuries. This guide provides clear, step-by-step instructions on how to complete the form online in a user-friendly manner.

Follow the steps to fill out the 2-920 Form effectively.

1. Click the ‘Get Form’ button to obtain the form and open it in your editing application.
2. Begin by filling out Part A, which details the patient with the suspicious injury. Enter the patient's full name, birth date, and gender. If applicable, include the patient's contact information and ensure to provide the date and time of the injury.
3. In this section, provide the location of the injury and include a description of the incident as provided by the patient, along with details about any identified suspects or relationships.
4. Proceed to Part B, where you will document the law enforcement agency that was notified. Include the date and time of reporting, the name of the person who received the report, and their title.
5. Finish with Part C, which requires the name of the health practitioner filing the report, their employer’s details, and their signature, along with the date signed.
6. Once all sections are completed, review the form for accuracy, then save your changes, and choose to download, print, or share the completed form as needed.

Complete your documentation online today!