Please complete this form to report the use of a GTC Bleeding Control Kit. We appreciate you taking the time to provide this information, as it aids us in advocating for the care of injured Georgians. Rest assured, we will not request any information that identifies the patient; however, the county of the incident will be recorded to ensure your RTAC Coordinator can follow up for replacement. We will work to replace the kit as soon as possible, based on available inventory and program funding.