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Taser M26 Demo Report

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ADVANCED TASER® DEMO REPORT
Date ____________ Officer’s Name with rank: ______________________________
Department: ____________________________
Age: _____ Sex: _____ Height: _____

Build: ( ) Heavy ( ) Med. ( ) Trim

Did dart contacts penetrate the subject’s skin? Y / N
Regarding the ADVANCED TASER: Did the application cause injury: Y / N.
If yes, was the subject treated for the injury: Y / N.
Please place and "X" over the area where the applications was applied.
APPLICATION AREAS - Points of contact

Please list effects, comments and or how it felt. (Note, could you fight back?):
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

This information is requested for the International Association of Chiefs of Police Use of Force
National Database Project and published in our medical research.
May we quote your comments
Signature: ________________________________________