Get Non-fatal Drowning In Arizona

This guide provides clear instructions on how to complete the NON-FATAL DROWNING IN ARIZONA form online. Filling out this form accurately is crucial for effective reporting and intervention.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to access the document and open it in your editor.
2. Begin by entering the date of the incident in the format MM/DD/YR. Then fill in the hour of the incident using the 24-hour format.
3. Enter the incident number and the patient's name, followed by their date of birth.
4. Specify the type of water involved in the incident by checking the corresponding box that describes the location, such as pool, lake, or bathtub.
5. Select the type of dwelling or facility where the incident took place.
6. Record the patient's activity and location immediately prior to the incident.
7. Describe the victim's status when found in the water, including any specifics about respiratory effort at the time of removal.
8. Estimate the duration of anoxia and provide details on bystander actions prior to emergency services' arrival.
9. State whether the victim had formal swim instruction and indicate disposition if known.
10. Fill out the follow-up and date patient was last seen, including any impairment noted.
11. Finally, describe the apparent circumstances surrounding the incident in detail.
12. After completing the form, review all entries for accuracy before saving changes, downloading, printing, or sharing the form as needed.

Submit your completed NON-FATAL DROWNING IN ARIZONA form online to ensure proper reporting and response.