Florida EMS Association
Serving All Florida EMS Responders

Education and Forms




FEMSA suggest that all facilities that transport children, the elderly, or pets perform a triple check system so that a confirmation is performed that the transport vehicle is empty before locking up. 


Driver writes the name of those picked-up on the form as they enter the vehicle in the Embarked section

Driver takes the passengers off the vehicle in order from the list and writes their name in the Disembarked section. 

Driver signs the form attesting the list is correct and visually verifies that the vehicle is empty of all passengers.

A second person, within 5 minutes from the facility, visually verifies the vehicle is empty of all passengers and signs the form. 

The forms are kept in a file, in order of date performed. 

Click on the file you wish for download. Your download may appear at the bottom of your Browser. 


Passenger List for Facilities Check Sheet.docx
13.5 KB
 

Passenger List for Facilities Check Sheet.pdf
41.6 KB