SERIES #

SERIES TITLE AND DESCRIPTION

VITAL

RETENTION INSTRUCTIONS

LGMED-001

ACTIVITY REPORTS

Record of daily activities such as time out, time in, mileage, number of passengers, number of stops, collections, gas and oil used, and driver’s name.

Retain at agency 5 yrs; destroy.

LGMED-002

PATIENT REPORTS

Show equipment used, patient locations, nature of call, time factors, primary complaint, vital signs and other physical signs, site of injury, care rendered, medicine ordered, changes in condition, name and address of patient, driver, attendant, and type of payment. May also include related information such as EKG (electrocardiogram) results.

Retain at agency 5 yrs; successful audit; destroy.

NOTE: Medical records should be considered confidential.

LGMED-003

PATIENT REFUSAL FORMS

Verify patient’s refusal of treatment.

Retain at agency 5 yrs; destroy.