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Submission information
Submission Number: 27
Submission ID: 11636
Submission UUID: 1a33c675-19f3-44e2-994a-4e2a056740b1
Submission URI: https://www.uottawa.ca/faculty-medicine/form/safe-ride-home-form
Created: Wed, 05/14/2025 - 15:48
Completed: Wed, 05/14/2025 - 15:48
Changed: Wed, 05/14/2025 - 15:48
Remote IP address: 162.158.126.100
Submitted by: Anonymous
Language: English
Is draft: No
Webform: Safe Ride Home Form
Student Number: 8760593 First Name: Austin Last Name: Gerhart Date of service: 2025-05-11 Your on-call shift’s start time: 17:00 Your on-call shift’s end time: 08:00 Proof of on call shift: https://www.uottawa.ca/faculty-medicine/system/files/webform/safe_ride_home_form/11636/Screenshot%202025-05-14%20at%2012.55.01%E2%80%AFPM.png Proof of payment: https://www.uottawa.ca/faculty-medicine/system/files/webform/safe_ride_home_form/11636/Uber%20Receipt%20May%2011th.pdf Proof of payment 2: {Empty} Name of hospital where work was performed: General Home program: Internal Medicine Comment: {Empty}