cfnar

[select name="unit" value="591|Medic 1|517"] dispatched [select name="Type" value="|ALS emergent|ALS nonemergent|BLS emergent|BLS nonemergent"] for transfer from [text name="sending" memo="Sending facility"] to [text name="receiving" memo="Receiving facility"]. [text name="extra" memo="Delays/PPE"]

Patient [select name="complaint" value="|voiced no complaint|complained of "][text name="complaint"].

[textarea name="hx" memo="Hx"]

Patient [select name="move_1" value="|transferred from facility bed to stretcher via two-man draw sheet|ambulated from facility bed to stretcher w/ assistance|ambulated from facility bed to stretcher w/o assistance"]. Secured to stretcher by 5 straps and 2 side rails. Stretcher loaded from facility to ambulance [select name="ambincident_1" value="w/o incident|w/ incident: "][text name="ambincident_1"].
[select name="transport" value="|Transport unremarkable|During transport, "][text name="transportactivity"].
Stretcher unloaded from ambulance to facility [select name="ambincident_2" value="w/o incident|w/ incident: "][text name="ambincident_2"]. Patient [select name="move_2" value="|transferred from stretcher to facility bed via two-man draw sheet|ambulated from stretcher to facility bed w/ assistance|ambulated from stretcher to facility bed w/o assistance"].

[select name="rnreport" value="|Verbal report given to RN|RN declined verbal report"]; transferred care [select name="careincident" value="w/o incident|w/ incident: "][text name="careincident"].

[select name="unit" value="591|Medic 1|517"] cleared.
dispatched for transfer from Sending facility to Receiving facility. Delays/PPE

Patient .

Hx

Patient . Secured to stretcher by 5 straps and 2 side rails. Stretcher loaded from facility to ambulance .
.
Stretcher unloaded from ambulance to facility . Patient .

; transferred care .

cleared.

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.55, 20 form elements, 31 boilerplate words, 8 text boxes, 1 text areas, 11 drop downs, 20 total clicks
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