Fraud Blocker

Daily Report

  • Today’s Date
    MM slash DD slash YYYY
  • Select a Location
  • Prepared By
  • Enter any other staff members that visited your location today. Select “None” if nobody visited. You must select an option.
  • Enter the quantity of UT BLS TB physically present at this location today.
  • Enter the quantity of UTP ACLS TB physically present at this location today.
  • Enter the quantity of UTP PALS TB physically present at this location today.
  • Briefly summarize any customer’s issues encountered at your location today and any other incident that might require follow up from the main office.
  • What supplies do you need at your location? Select all that applies. Hold Control Key to select more than one.

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