This is a generic Bed Report Form.

It is for reporting available beds at a facility.
You enter your Jurisdiction, Group, or entity name at the top right.
Example: Basset County RACES or San Bernardino County Health. This form will total the available bed counts for you.

Based on W2SRP original Marion County Florida form.


You can save your completed HTML to a text file. This will allow you to reload the form with ALL entered form data. You do this prior to submitting the form. Then you can open a new form and load the saved HTML form data. NOTE: Date and Times will be the previous, so change if needed. It will save the info as a text file with the Date and Time as the text file name. Now you can use any browser, save your form, (as many versions as you like), and then re-populate.

This form can be customized with a name by using the "Setup" button on the top right. This entry will stay with the form until you change it.

* NOTE on printing:

Printing this form is dependent upon your selected printer and its settings. Various Web Browsers and and their viewing sizes are not all the same. Printing from a browsers print function may be different from the operating systems default print mode. Select what works for you, for both printing and viewing. You may print direct to the printer as a HTML or save as a PDF then print the PDF. In some instances Landscape mode may print better than Portrait.

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HOSPITAL BED REPORT

 Click to add your agency or group 
           
         

  As of Time:    Date:             
  

Customize Hospital Bed Report

This is a generic Bed Report Form.

It is for reporting available beds at a facility.
You enter your Jurisdiction, Group, or entity name at the top right.
Example: Basset County RACES or San Bernardino County Health.
This form will total the available bed counts for you.

Based on W2SRP original Marion County Florida form.

Back to links
   Name of Reporting Facility:  
   Contact Person:  
   Contact Phone Number:  
   Contact Email Address:
           Type  Available                                               Notes
  Emergency Beds        
  Pediatrics        
  Medical / Surgery         
  Psychiatry        
  Burn        
  Critical Care        
          
          
  TOTAL: 
 DEFINITION: Physical Available Beds = Staffed + Un-staffed Beds

    Addtional Comments:
   

                                                           
Version 9.1