MEDICAL STATUS REPORT [MEDSTAT]
LINE 1 — DATE AND TIME______________________________(DTG)
LINE 2 — UNIT________________________________________(Unit Making Report)
LINE 3 — TYPE________________________________________(Type of Medical Status Report: ASHORE REPORT or AFLOAT REPORT)
LINE 4 — COMMAND__________________________________(Name of Designator of Reporting Command or Facility if Ashore; Ship Name, Type and Hull Number)
LINE 5 — POC_________________________________________(Name of Medical Point of Contact)
LINE 6 — AVAILABLE__________________________________(Number of Cots or Hospital Beds Available)
LINE 7 — OCCUPIED___________________________________(Number of Cots or Hospital Beds Occupied)
LINE 8 — OVERFLOW__________________________________(Number of Cots/Holding Beds Occupied)
LINE 9 — FULL ________________________________________(Number of Cots/Holding Beds Occupied)
LINE 10 — WAITING ___________________________________(Number of Patients Awaiting Evacuation Out of/From Command’s Area of Responsibility Since Last Report)
LINE 11 — MEDLOG____________________________________(Number of Days of Class VIII Supplies on Hand)
LINE 12 — PROBLEMS__________________________________(Unresolved Problems and Anticipated Problems/ Issues Affecting Reporting Command)
LINE 13 — ASSESSMENT________________________________(Commanding Officer’s Assessment of Operational Capabilities and Ability to Continue Medical Support (Mandatory Entry))
LINE 14 — NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report)
**Report lines 3 to 14 as a group when reporting the medical status of more than one command, facility, or ship.
LINE 15 — AUTHENTICATION___________________________(Report Authentication)
