Get First Aid Patient Assessment Form 2020-2026

The First Aid Patient Assessment Form is essential for documenting an individual's injury or illness. This guide provides clear instructions to assist users in accurately completing the form online, ensuring all necessary information is captured efficiently.

Follow the steps to fill out the First Aid Patient Assessment Form online

1. Click the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Enter the date and time of the illness or injury at the designated fields, using AM or PM as appropriate.
3. Document the date and time the incident was reported to first aid, again using AM or PM.
4. Record the time of arrival at first aid if the patient walked in, or leave it blank if it does not apply.
5. If applicable, fill in the time on scene where the individual was assessed.
6. Complete the fields for the employee's name, date of birth, and their doctor's name, ensuring accuracy.
7. Provide details about the employer's name and their phone number.
8. Enter the contact person for the patient if different from their employer.
9. Utilize the Glasgow Coma Scale by marking the appropriate responses for eye opening, verbal response, and motor response.
10. Document the patient's chief complaint clearly, providing a brief description.
11. Fill in the vital signs section, including time, respirations, and pulse measurements.
12. Describe the mechanism of injury or history of illness in the designated area.
13. Record any physical findings, including pupil size and reaction, marking appropriately.
14. List any known allergies of the patient and document any medications they are currently taking.
15. Indicate any interventions that were performed by checking the relevant boxes.
16. Identify definitive treatments checked, ensuring to explain any additional treatments that may have been applied.
17. Provide recommendations regarding the patient's return to work, follow-up needs, or if medical aid is required.
18. Specify the method of transport used, checking all applicable options.
19. Note any changes in the patient's condition, providing explanations where necessary.
20. Print the names of the first aid attendant (F.A.A.) and their signature, along with the F.A.A. certification number.
21. List the names of any witnesses, including their print names.
22. Complete the employer's mailing address fields, including street, city/town, and postal code.
23. Obtain the employee's signature to confirm their review of the information documented.
24. Finally, save your changes, and choose to download, print, or share the completed form as needed.

Complete your First Aid Patient Assessment Form online today to ensure proper documentation and follow-up.