MIRF REPORT
Request:
Dizziness
Campus:
Fallbrook
Location/Building:
[68]
Date of Incident:
July 20, 2025
Time of Incident:
10:05 AM
Number of Patients for this Incident:
[75]
List Patient(s) Name, Age, Parent/Guardian (if under 18),… :
Julie Bergen
Describe Medical Event:
Patient stated she was dizzy, started this morning while driving to church. Has a history of vertigo.
Actions Taken by Team Members:
[79]
Number of NCSM Team Members Involved:
[81]
List Name(s) of NCSM Team Members Involved:
Amber Mendes
Was medical attention accepted?”:
Yes
Medical attention was refused by (name and relationship to… :
Was 911 emergency service called?:
No
Was patient transported via 911 emergency services?:
No
What hospital was victim transported to?:
NCS team lead:
[249]
If any revisions or updates are needed to be made to this incident, complete the form below.
Please select a valid form