Primary Care ParamedicAdvanced Care Paramedic
—Please choose an option—DartmouthSydneyYarmouthStellartonMonctonFrederictonBathurstSaskatoon
Preceptor First Name:
Preceptor Last Name:
Preceptor's Partner First Name:
Preceptor's Partner Last Name:
Date of Incident:
Time of Incident:
Location of Incident:
Account of Events:
Description of action(s) taken:
Management of Operating Company/Hospital made aware of incident?
—Please choose an option—YesNo
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