First Responder Assessment Form

Try our free first responder assessment form on your mobile device for accurate treatment purposes.

Gather critical medical information from the patient when you are the first responder at the accident scene. Record the person's vitals and given treatment so medical staff can provide the right follow-up care when the patient arrives at their medical facilities.

Try our first responder assessment form for free on any mobile device with a free trial of IntouchCheck mobile form software. Sign up for a free trial today and ask your Intouch specialist to load this pre-built form into your account.

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As a first responder to an accident scene, you need to gather vital information about the patient's current condition and medical history so the data can be used to provide the appropriate treatment. The first responder assessment form allows you to take notes about the patient's provided medical history, current injuries or health concerns and provided treatment. With this assessment, you can send the report to medical doctors, emergency medical technicians and the patient so they have this information for their records and to get follow-up treatment.

Form Details

Have accurate data about a patient's current health condition when providing first responder assistance. Our first responder assessment form allows you to record gathered patient information at the accident scene so that you can provide the right initial treatment as well as provide medical information for medical doctors who will be caring for the patient later on. You can record the patient's vitals, emergency contact information, medical treatment you provided, pre-existing conditions and current medications so you properly treat the patient at the scene.

Our first responder assessment form has pre-built fields available with common patient information and medical categories. You can also customize the template form with the desired categories when your InTouch specialist loads the template to your account. You can access the form from any mobile device when you are at the scene so you don't have to bother with flipping through paper documents and clipboards to write down the required information. Fields that are available in the assessment template:

  • Event or accident location
  • Patient's personal information
  • Emergency contact information
  • Initial priority assessment
  • Pain summary
  • Patient's vitals
  • Medical information
  • Accident details
  • Treatment details
  • Patient authorization signature for treatment

Customize Your Digital First Responder Assessment Form

We know that every business is unique, and your forms should reflect that. Our ready-to-use template is a comprehensive list of industry standard fields, but it is most useful when customized to reflect your own needs. The IntouchCheck platform makes it simple to quickly customize the mobile form template to meet the individual needs of your company and goals; questions, fields, or sections can be quickly removed, and new queries or fields can be added in the appropriate places to fit your project.

Create Your Own First Responder Assessment Form Template

Already have processes and procedures in place? IntouchCheck’s straightforward interface makes it fast and easy to create your own forms, where you can customize the sections, categories, questions, and types of data/image capture fields. We’re here to help you get started! Try IntouchCheck for free, and see how easy it is to streamline your business processes.