Community Registration

🚑

Transport Request

Section 1

📍Transport From

Facility Name

Room #

Address

Contact Phone

Preferred Pickup Date / Time

🏥Transport To (optional — if known) ✓ Filled ▼

🔓 Fill Transport From details, then lock to begin adding patients.

🕐

Registration Timestamp

Section 2 ▶

🏷️

Wristband ID

Section 3

Wristband ID (optional)

👤

Demographics

Section 4

👇 Tap the button — name, DOB, age, phone, gender

Registration Type

👤 Person 🐾 Pet ♿ Belonging

Appended to Additional Information on submit.

🔗 Associate Person ID (optional)

Scan owner's wristband to link this Pet/Belonging.

First Name *

Last Name *

Date of Birth Preferred over age.

Age (years) Enter if DOB unknown.

Phone

Gender

Male Female Other / Unknown

📍

Address

Section 5

👇 Tap the button — street, city, state, ZIP

Street Address

City

State

ZIP Code

📷

Photos

Section 6

No photos added yet. Photos are optional.

🩺

Additional Information

Section 7

👇 Tap the button — speak your notes

Additional Information *

0

Max 255 characters. Fields below are appended automatically on submit.

🙋

Reporter Information

Section 8

This is about you — the person submitting this report. All fields are optional.

Reporter First Name

Reporter Last Name

Reporter Phone

Relationship to Missing Person

Submitting to Pulsara

Community Registration

Transport Request

Registration Timestamp

Wristband ID

Demographics

Address

Photos

Additional Information

Reporter Information

Patient Queue

API Environment

Authentication

Form Mode

Session Token Settings

Incident Setup & QR Code

📱 QR Code — Share with Registrants

Activity Log