SWORBHP Newborn Delivery Award

If you have done a call that meets the criteria to be considered for a Prehospital Newborn Delivery Award, please complete the following form and submit to the Base Hospital for verification. Please do not include any personal patient information on this form.

SWORBHP Prehospital Newborn Delivery Award Criteria:

The paramedic crew delivered the baby, OR
The paramedic crew assisted a midwife or family member in the delivery of the baby.
NOTE: If the baby has been delivered prior to paramedic arrival on scene, the paramedics do not qualify for the newborn delivery award. Delivery of the placenta does not qualify for this award.

Call Date:

Service:

Run #:

Email address of person completing this form:

Paramedic Information:

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

Paramedic Email

OASIS #: