Daily Report 2026

Frontline Medical EMS

Unit & Date

You are reporting about YESTERDAY. This report needs to be completed by 1000 Hours.

Med Unit Number ("FL ##") *

Isolation Unit Number ("FL ##") *

Date You Are Reporting About *

Name of Incident *

Frontline Medical Personnel — Daily Health Check

Test if symptomatic

Last Name	ALS	BLS	Symptoms	Other

Projected Crew Member Demob Dates

Crew Member Name	Demob Date	Projected Replacement

Shipping Address Information

Name of Camp

Street Address

City, State, Zip Code

Location of Camp

Any Other Delivery Info

Incident Management Team

Incident Management Team *

Medical Unit Leader Information

MEDL First Name

MEDL Last Name

MEDL Phone #

IMT Issues

Question	YES	NO
Any issues with IMT?
Trailer Pumping Issues
Are handwash stations readily available? Within 100' of MU
Are restrooms readily available? Next to MU
Any reciprocity issues with other providers?
Any FUEL issues?

If Any Issues, Describe Here

Daily Duties

Shift tickets — Pink/Blue go to finance, Yellow goes into FL envelope, White stays in book OR; Submit via email, insure a copy gets sent to [email protected] and [email protected].

Task	Completed	Not Completed
STATS (copy to MEDL)
INJ LOG (copy to MEDL)
SUPPLY INVOICE
SHIFT TICKET
Crew Medical Assessments
Inventory Supplies
Order Supplies
Restock Bins
Organize Supply Tent
Clean Floors
Wipe Down Interior
Clean Bathroom
Clean Coffee Area
Clean Refrigerator
Restock PT Lunch
Empty Interior Trash
Remove Exterior Trash
Fill Potable Tank
Empty Gray Tank
Empty Black Tank
Clean Infect. Exam Area

Damages

Question	YES	NO
Any Damages to Med Unit or Frontline Medical Equipment?

Damages — If YES, List Here

Supplies

Question	YES	NO
Any supplies needed?
ALS Supplies Needed?
OTC Supplies Needed?
Local Purchase Supplies Needed?

Supplies — If YES, List Here

Daily Supply Invoice Total *

Current Final Invoice Total *

Treatments

Advance Treatments for Cost Analysis — ALL steroid injections and Toradol injections go on shift tickets as RxTx.

	Number of Units on Invoice
Kenalog 40
Toradol 30
IV per 1000ml
Wound Closure Supplies
ADV Wound Care
ADV Cardiac Meds
ADV Nausea GI Meds
ADV Allergic Reaction Meds
Temporary Dental
ADV Corneal Eye Exam
ADV Lab Test
Rx Antibiotics

COVID / FLU Testing Results

	Totals
# POS COVID
# POS FLU
# RSV
# STREP

Narcotic Count

ALL narcotics administered and wasted MUST be documented on PCR as well as PAPER LOG. Paper Log to be signed at ALL crew changes and Narcotic Administration.

Daily Narcotic Count

	NUMBER OF VIALS	SEAL #
MORPHINE
FENTANYL
VERSED
KETAMINE

Misc Medication Count

	# of Vials
Kenalog
Solu-Medrol
Toradol
IV Solutions per 1000cc
IV tubing per unit

Name / License # of ALS Provider Responsible for Narcotics

First Name

Last Name

License # — State

Name of Person Submitting Daily Report

First Name *

Last Name *