Chirurgeon Report

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Chirurgeon Reporting Schedule

Event reports are due within 2 weeks after the event.
Mid-year report (due June 1) - All chirurgeons and Chirurgeon in Training report.
Domesday (due December 1) - All chirurgeons and Chirurgeon in Training report.
- Must include a photo-copy of First Aid, C.P.R., and SCA Membership.
New First Aid, CPR, or SCA Membership expiration dates can be reported anytime electronically using the certification update form.
Incidents involving minors or requiring *medical* intervention must be reported within 24 hours.
This includes:
- Any time EMT or paramedics are called
- When anyone is recommended or sent to a hospital or clinic (including urgent care) from site.
- Formal referral made to an on-site or off-site MD.
These incidents must be reported within 24 hours whether or not the person actually follows through with medical intervention.

Current Status: Chirurgeon-in-trainingChirurgeonMentor Chirurgeon First Aid Certification Expiration Date:

CPR Expiration Date:

Check if you are sending updated certifications through the mail.
I have been CIC at the following events (event name, group and date):

I have worked as a chirurgeon at the following events (event name, group and date):

Incidents that you feel need special notation:

Questions/Comments/Concerns: