EMS Report
The EMS report contains any known detail of physical injuries, location of the occurrence of injury, and any pre-hospital treatment.
 | Fields that are required contain an * and fields that are recommended contain a +. |
The following table contains the required and recommended fields for the EMS report.
| Field | Req / Rec |
|---|---|
| Claim Number | Required |
| Incident Date | Required |
| Street Address Number or Name | Required |
| Cross Street Name | Recommended |
| City | Recommended |
| State or Province | Required |
| Report Number | Recommended |
| Last Name | Required |