Dispatch Log
Call received (Date and Time)

Source of call

Call back number

Response location (Name of destination or address)


Unit dispatch time
Unit en route time
Time unit arrived on the scene
Time unit left the scene
Time arrived at destination
Destination of patient (Name of destination or address)
Full Name and Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.