Supervisor Checklist

Supervisor Checklist

Supervisor Checklist

Patient Care Provider
Driver/Operator Name

Airway

IV supplies

PERSONAL PROTECTIVE EQUIPMENT

OTHER

BANDAGING AND SPLINTING

CLINICAL SUPPLIES

MEDICATIONS (ORAL)

MEDICATIONS (injectable)

Please use this box to describe any items that may require special detail, repair or resolution. Please report any abnormal findings to your supervisor.
Please sign using a stylus or finger on any touch screen device.
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