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.

Prehospital Newborn Delivery Criteria:

Paramedic crew delivered the baby.
A Midwife or family member is on scene, delivery has not yet taken place, and Paramedic crew assists in the delivery.
NOTE: if baby has already been delivered and you transport, this does not qualify.

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 #: