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Automatically assigned

n/a (automatically assigned by PSRP online system)

Check all that apply

Select all that apply.

Checkbox

Checkbox (multiselect)Dropdown (single select)

Harm algorithm link

PSRP Harm Categories and Algorithm (pdf)

Made required when triggered

Made required when triggered.

No additional guidance

No additional information provided.

Other selection text

If “Other” is selected, a text box for a description will also appear.

Radio Button

Radio button (single select)

Select only one

Select one.

Serious event

This event type is always considered a reportable event, regardless of level of patient harm.

Staff contact info

Patient Safety Reporting Program (PSRP)
Email the PSRP Team
503-928-6158
1-855-470-4079
for TTY, please call 711

You can include up to five

One instance of this question is required to submit a report, but you may include up to five.

Reusable Text