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The form contains required questions that must be completed in order to submit any Patient Safety Reporting Program (PSRP) report. Depending on the event type selected, there may be additional event-specific questions that must be completed prior to submission. The system will automatically save a partially completed report regardless of whether the required fields are completed.

The following questions are required for any adverse event PSRP report:

General Information

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Initial Build

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SE 8/6/2021

Staff Review

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Suzanne Wood

Comms Approval

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KO 10/04/2022