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Patient Care Report (PCR)

Clinical Externship Documentation Portal

This page provides clinical externship students with a secure and convenient place to submit their Patient Care Reports (PCRs). Use this form to document each patient encounter, ensuring your clinical hours, skills, and experiences are accurately captured for review. Please complete all required fields thoroughly to support timely evaluation and maintain compliance with your program’s clinical requirements.

📝 Before You Submit

  • Complete one PCR for each patient contact as required by your program.
  • Number your patients by the number of contacts
  • DO NOT PUT THE PATIENT’S NAME ANYWHERE IN THE REPORT
  • Ensure vital signs, assessments, interventions, and outcomes are documented as accurately as possible.
  • Use clear, professional language in your narrative and avoid abbreviations that are not standard.
  • Verify that all required fields are filled out before submitting the report.

These reports are reviewed by faculty and may be used to verify competencies, skills, and clinical progression.

Submit Patient Care Report

Complete all applicable sections below. Once submitted, your PCR will be securely stored and made available for instructor and program review.

    Patient Care Report (PCR)

    Provider Information
    Student Name


    Student Email


    Student Level*


    Course / Cohort


    Clinical Site / Agency


    Clinical Shift / Ride #


    Incident Date & Times

    Today's Date


    Unit Times

    Dispatch Time (HH:MM)


    Enroute Time (HH:MM)


    On Scene Time (HH:MM)


    Depart Scene Time (HH:MM)


    Hospital Arrival Time (HH:MM)


    Call Complete (HH:MM)

    Patient Information

    Patient Number


    Patient Priority


    Patient Date of Birth (DOB)


    Patient Age


    Patient Gender


    Chief Complaint


    Mechanism of Injury / Nature of Illness


    Primary Assessment – ABCs

    Airway


    Breathing


    Circulation


    Neurological Status – Glasgow Coma Scale

    Eyes (4–1)


    Verbal (5–1)


    Motor (6–1)


    Total GCS


    Speech


    Skin & Respiratory Assessment

    Skin Moisture


    Skin Color


    Lung Sounds

    Right Lung


    Left Lung


    Perfusion & Pupils

    Pulse Rate


    Pulse Quality


    Right Pupil


    Left Pupil


    Pupil Equality


    Vital Signs

    Set 1

    Time (HH:MM)


    LOC


    Pulse


    BP
    /

    Respirations


    SpO2


    BGL


    Pain (0–10)
    Set 2

    Time (HH:MM)


    LOC


    Pulse


    BP
    /

    Respirations


    SpO2


    BGL


    Pain (0–10)
    Set 3

    Time (HH:MM)


    LOC


    Pulse


    BP
    /

    Respirations


    SpO2


    BGL


    Pain (0–10)

    Interventions (Summary)


    Intervention Log

    Row 1

    Intervention Time (HH:MM)


    Description


    Patient Response
    Row 2

    Intervention Time (HH:MM)


    Description


    Patient Response
    Row 3

    Intervention Time (HH:MM)


    Description


    Patient Response
    Row 4

    Intervention Time (HH:MM)


    Description


    Patient Response
    Row 5

    Intervention Time (HH:MM)


    Description


    Patient Response

    SAMPLE History

    Signs/Symptoms


    Allergies


    Medications


    Past Pertinent History


    Last Oral Intake


    Events


    Patient Assessment Findings


    Narrative


    Transfer of Care


    Hospital/Agency Name


    Trauma Level


    Preceptor Information

    Preceptor Name


    Preceptor Email


    Save and Resume Later


    Related Clinical Documentation

    Need to complete evaluations related to this clinical experience? Use the links below.

    Questions about clinical documentation? Contact
    info@texasrescuemed.com.