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Start & End Shift Report
Crew Member #1 (First & Last Name)
*
Crew Member #2 (First & Last Name)
*
Unit #
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Start Shift Report
Current Millage
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Was the ambulance safely secured and found in the same spot?
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Yes
No
Any equipment found on the ambulance?
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Yes
No
Is the Employee Handbook located?
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Yes
No
Do the brakes function normally?
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Yes
No
Steering wheel working?
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Yes
No
Horns and sirens working?
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Yes
No
Secured fire extinguisher?
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Yes
No
Is the tire tread depth within limits?
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Yes
No
Does the back up camera work?
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Yes
No
Windshield wipers working?
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Yes
No
Turn signals both working in front and back?
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Yes
No
Is the ambulance clear of trash?
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Yes
No
Images Of Inside Front Cabin
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Upload Images
Images Of Inside Back Cabin
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Upload Images
Coolant level within limits?
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Yes
No
Engine Oil level within limits?
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Yes
No
Diesel Fuel tank full?
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Yes
No
Image of Diesel Fuel Tank Level
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Upload Images
End Shift Report
Current Millage
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Were all PCR’s Accurately completed 100% without errors?
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Yes
No
Was all paperwork turned into Operations?
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Yes
No
Was any equipment used?
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Yes
No
Did the ambulance get fueled to full?
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Yes
No
Image of Diesel Fuel Tank Level
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Upload Images
Did all the trash get thrown away and spills cleaned up?
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Yes
No
Images Of Inside Front Cabin
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Upload Images
Images Of Inside Back Cabin
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Upload Images
Is there any noticeable damage to the ambulance?
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Yes
No
Did the ambulance experience any mechanical issues?
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Yes
No
Is the tablet secured in the console?
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Yes
No
Outside Images of Ambulance
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Upload Images
Is the ambulance safely parked and secured?
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Yes
No
Was the stretcher and back of the ambulance cleaned and disinfected?
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Yes
No
Was all dirty linen put inside laundry bag?
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Yes
No
Was the Daily Inventory sheet completed?
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Yes
No
If you answered “Yes” to any of the questions above, please explain:
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