Name:* Age:* Rank:* Company:* Incident No.: Incident Date:* MM slash DD slash YYYY Incident Time:* : Hours Minutes Incident Address:* PPE worn properly*YesNoN95 MaskSafety GogglesEMS GlovesExposure Risk High Low Chief reported exposure to: Pertinent information:Was patient transported to hospital? Yes No Which hospital?RI HospitalMiriamRoger WilliamsFatimaKent CountyPawtucket Memorial Share this story email icon. Click to share on email twitter icon. Click to share on twitter facebook icon. Click to share on facebook linkedIn Icon. Click to share on LinkedIn
