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Incident Record Card

Fill out as much of the incident record card as you can before leaving the scene. It contains valuable information for emergency staff and may help further treatment of the casualties.

For each casualty:

  • Name:
  • Date of birth:
  • Allergies:
  • Medication:
  • Previous medical problems:
  • Time of last meal / drink:
  • What happened:
  • Injuries:
  • Treatment given:

For your group:

  • Exact location:
  • Type of incident: (what happened)
  • Hazards in area:
  • Access to the area: (how to get to you)
  • Number of casualties:
  • Equipment needed:
  • Time:
  • Date:
  • Name of recorder:
  • Signature:

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