Over and Under Triage Section
This is for all CODE HEART AND STEMI activations regardless of final diagnosis.

Question Title

* 1. Contact Information

Question Title

* 2. Please select date of activation (not today's date)

Date

Question Title

* 3. If available, please add Texas EMS Wristband Number

Question Title

* 4. Activations This patient's unique identifier is the first 3 letters of the month followed by the number of the Activations for this month.
(for example Mar-1 is the first patient activation for the month of March, Mar-2 is the second patient activation for the month of March, etc.)

Question Title

* 5. How did the patient arrive to the facility?

T