Surge Forms

The Alliance is currently under contract with the State of Louisiana to provide Emergency Response Units and Staff in response to natural and man-made disasters.  All Louisiana providers are eligible to participate in response under this contract.  For more information, please contact the Alliance office. 

Related Documents:

2021 Season Forms

  1. Introduction

  2. Deployment Guide

  3. Emergency Response Documentation Forms Listing

  4. State of Louisiana Surge Unit Registration Form

  5. Daily Activity Log Instructions

  6. Daily Activity Log

  7. Patient Care Report Instructions

  8. Patient Care Report

  9. Patient Care Report Log Instructions

  10. Patient Care Report Log 

  11. LRAA Radio Fleet Map

  12. State of Louisiana Surge Unit Demobilization Form

  13. ALS / BLS EMS Unit Hour Log

  14. Crew Change Form

Emergency Response