HomeMy WebLinkAboutJ. Hernandez, K. Fuller - VAD Skills Day - 9/27/2019TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 0/0 /9 I -HO 63
FY &V BUDGETED G�UU
EXPENDED YTD
THIS REQVEST _ 3v
LEFT AFTER THIS ✓�
REQVEST
DATE
Sinal - Clerk/Finance Copy - Department
NAME(S) AND POSITION(S): DATE:
Jason Hernandez, Medical Supervisor September 27, 2019
Kyle Fuller, FF, Paramedic
NAME OF CLASS / MEETING: DESTINATION: University of Iowa Hospital
Ventricular Assist Device (VAD) Skills Day Dept. of Cardiology
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
September 27, 2019
PURPOSE OF TRAVEL/TRAINING:
RETURN DATE:
September 27, 2019
DATE(S) OF MEETING:
September 27, 2019
Jason and Kyle will be obtaining hands on instruction and clinical insight on Ventricular Assist Device's (VAD's) and VAD
patients in order to bring this back to the department for Emergency Medical Services (EMS) training in October. We
have several VAD patients within WFR response areas so this training is very important to the quality of their prehospital
emergent care.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST:
LODGING
TAXI
X MEALS PARKING
REGISTRATION AIRFARE
MILEAGE/FUEL MISCfTOLLS
TOTAL FOR ALL: $ 30.00
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF W
7
DEPARTMENT HEAD
PRIVATE VEHICLE
BUDGET LINE ITEM: 010-12-1410-1346
X GRANT REIMBURSABLE
YES NO
X REQUIRED CERTIFICATION
YES NO
TOTAL: $ 0.00 PER PERSON
I APPROVE THIS TRAVEL REQUEST
MAYOR
10
f %
DATE DATE
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