Get Equipment Failure Report

Filling out the Equipment Failure Report online is a straightforward process that helps ensure critical incidents are documented accurately. This guide provides step-by-step instructions to assist you in completing the form effectively and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Identify the type of failure by selecting either 'Critical Transport Vehicle Failure' or 'Medical Equipment Failure'. Make sure to check the appropriate box.
3. Enter the agency name in the corresponding field. This identifies the company or organization you are representing.
4. Fill in the reporting party's name. This should be the person completing the report.
5. Provide the incident date and time. Enter these details as accurately as possible for record-keeping.
6. Input the incident number(s) to track the report and relate it to other records.
7. For critical vehicle failures, enter the vehicle number, mileage, and whether there's a patient on board.
8. Document the last preventative maintenance date, indicating if it was performed and the mileage on that date.
9. Record the initial unit times for dispatch, on scene, transport, and failure for critical vehicle failures.
10. If applicable, enter subsequent unit times for dispatch, on scene, transport, and hospital arrival.
11. For medical equipment failures, indicate if patient care was affected by selecting either 'Yes' or 'No'.
12. Provide a summary describing how patient care was or was not affected by the equipment failure.
13. List the equipment involved in the incident. This is critical for understanding the failure.
14. If biomedical equipment is involved, input the date of the last preventive maintenance.
15. Compile all information into the 'Description of Problem/Incident Summary/Actions Taken' section.
16. Before finalizing, review the form for accuracy and completeness, ensuring all necessary information is provided.
17. Once completed, save changes, and use options to download, print, or share the form as needed.

Complete your documentation online to ensure timely and efficient processing.