Fillable Miemss facility 48-hour report form for cardiac arrests TOWSON

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Miemss facility 48-hour report form for cardiac arrests TOWSON

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Supplemental Instructions
For Completing the
Maryland Facility AED Arrest Form for
Cardiac Arrests
THIS COMPLETED FORM CONTAINS CONFIDENTIAL
PERSONAL PATIENT INFORMATION AND SHOULD BE
HANDLED APPROPRIATELY.
1. COMPLETE FORM AND FAX TO ENVIRONMENTAL HEALTH & SAFETY
WITHIN 24 HOURS OF RESCUE TO THE NUMBER BELOW:
(410) 704-2993
DO NOT SEND FORM TO MIEMMS. After review, EHS
will send completed form to MIEMMS.
2. FOLLOW INSTRUCTIONS FOR COMPLETION ON ATTACHED
MARYLAND FACILITY AED REPORT FORM FOR CARDIAC ARRESTS.
3. ON FAX COVER SHEET, PLEASE PROVIDE CALL-BACK TELEPHONE
NUMBER AND EMAIL ADDRESS SO YOU CAN BE CONTACTED IF THERE
ARE ANY QUESTIONS.
4. ANY QUESTIONS SHOULD BE DIRECTED TO GREGG WOOD IN EHS
AT (443) 928-8677.
Towson University (Environmental Health & Safety)
8000 York Road
Towson
MD
21252
Towson University (EHS)
Towson University
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Miemss facility 48-hour report form for cardiac arrests TOWSON

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Completed 1 November 2019

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