Prehospital Care Report

PCRs, Refusals or Continuation Form Request
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​PCR Coversheet
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Prehospital Care Report (Version 5)

• ​Printable PCR
• Agency Copy (White Copy) - Front
• Agency Copy (White Copy) - Back
• Research Copy (Yellow Copy) - Front 
• Research Copy (Yellow Copy) - Back 
• Hospital Copy (Pink Copy) - Front 
• Hospital Copy (Pink Copy) - Back 
• DOH-3411 - Continuation Form

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