Request for a Splatt Tool

From Rob:

It's what we use for falls assessment
Symptoms experienced at the time of the fall, Previous number of falls or near falls,
Location of the fall,
Activity at the time of the fall,
Time of the fall and time on the floor.
Trauma associated with the fall.

As a CFR I have found snap medic really useful for that on the go data collection to then form my handover to crews but as I'm falls trained I go to a lot when I need to validate at scene and need to complete a splatt assessment as above this would be great if you would have something that we could use as a tool to add this into intervention log as a reminder of all the elements