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Get CT DAS Burn Injury Reporting Form 2013-2024

Juries 1. Immediately call the Local Fire Marshal in whose jurisdiction injury occurred. 2. Tell the Fire Marshal you are reporting a burn injury and give the following information: Victim's name, address and date of birth Injury severity Address where burn injury occurred Apparent cause of burn injury Date and time of injury Name and address of reporting facility Degree of burns and percent of body burned Attending physician Area(s) of body injured 3. Complete the Burn Injury Reporting Form.

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