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Forms

ADMINISTRATION

Appraisal Form

Appraisal FormAppraisal FormAuto Accident ProceduresBeneficiary FormCash Purchase Reimbursement FormCompensatory Time SheetComputer List Sign OutCPR Course Pre-RegistrationComputer Problem FormCPR Course EvaluationCPR Course EvaluationCredit Card Purchase Reimbrsement FormDivision Chief Extra Hours SheetEmergency Contact InformationEmployee Interview FormEmployee Orientation SkillsEmployee Right To Know ActFax SheetFirefighter Bill of RightsFixed Asset RecordHold Harmless Agreement - LaFrance AntiqueHold Harmless Agreement - District Activities and ApparatusGrievance Form 16-19 Contract.Insurance Information & ReleaseInter-Departmental CommunicationUniforms - Payback FormLocal Traveling ExpensesMileage Allowance Reimbursement Form 5-2019Mutual Aid/Automatic Aid Reimb.Notary AffidavitNotice of Eligibility and Rights & ResponsibilityOvertime Pay RequestPatient Authorization (HIPPA Compliance)Per Diem Reimbursement Meals Lodging Incidentals 5-2019Request for EMS Run ReportRadio & Technology Personnel Maintenance FormRequest for Leave of Absence (Admin Non-Exempt)Request for Leave of Absence (Admin Exempt)Request for Leave of Absence (Non-Admin) ** This can now be filled out online and emailed to (redacted)Retention LogSocial Security PermissionSpecial Assignment Pay Time SheetSpecial Pay EMS/CME Instructor Time SheetSpecial Duty Timesheet-WET Supervisor's Check ListThreat Incident ReportSpecial Event Donation FormUniforms- Screen Print Order Form Uniforms - Signal-15Waiver Employee Photos Vacation Buy-Back Request Form for Admin PersonnelVacation Leave (Bid)

 

APPARATUS

Accident /Damage ReportAccord Automobile Loss NoticeAccord General Liability NoticeDaily App Maintenance ChecklistDaily Non-Fire App. Maint. ChecklistDC-57 (543) Daily Vehicle InventoryE-56 (556) Daily Vehicle Inventory 1E-56 (556) Daily Vehicle Inventory 2W-58 (548) Daily Vehicle InventoryB-58 (550) Daily Vehicle InventoryE-58 (558) Daily  Vehicle InventoryProposed Equipment MovementS-57 (557) Daily Vehicle InventoryWeekly Vehicle MaintenanceWork Request FormMonthly Vehicle maintenance

BUNKER GEAR  

Bunker Gear Washing Log

EMS 

Ambulance / Hospital Incident ReportBLS Hurricane Shelter Bag E-56Comm Disease Exp. ReportEMS County Supply FormEMS Room Inventory 56/58HANDTEVY BAG Infection Control Exposure ReportMedications Expiring Next MonthMedication Inventory SheetNarcotic Key Activation AccountabilityPhillips MonitorRun Report ReviewStaff Vehicle BLS Trauma Bag InventorySunstar Medication Return FormWaste management Compliance Checklist

FIRE PREVENTION  

Fire Inspection for Occupancy w/KitchenInspection Detail ReportPrivate Hydrant LetterSafety Survey

HOSE FORMS

1.75" Hose Chart3" Hose Chart5" Hose ChartHose Service Testing Log

OPERATIONS 

Dispatching Errors

STATIONS 

Air Filter Replacement Schedule Station 57Cleaning Supplies InventoryMonthly Maintenance Support Services ChecklistQuarterly Facility Safety InspectionStation Duties Station 57Station Duties Stations 56 & 58Supply Order Form Non-Sani Chem

WORKERS COMP FORMS

Accident/Damage ReportInjury ReportLine of Duty Injury ProtocolPost Exposure ProtocolWorkers Comp Employee Worksheet