---
title: Emergency Room Post-Shift Wellness Check Form Template | Paperform
description: Confidential post-shift wellness check for ER staff to report trauma exposure, violence incidents, and emotional exhaustion. Connect healthcare workers with peer debriefing and support resources.
url: "https://paperform.co/templates/emergency-room-staff-post-shift-wellness-check"
type: static
generatedAt: "2026-03-28T00:43:46.039Z"
---

[← Back to free form templates](/templates/)    ![Emergency Room Staff Post-Shift Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/emergency-room-staff-post-shift-wellness-check.png)
    [Preview](https://_preview.paperform.co/ai-template/emergency-room-staff-post-shift-wellness-check) [Use this template for free](/create?ai-template=emergency-room-staff-post-shift-wellness-check)    [Emergency & Crisis Forms](/templates/category/emergency-crisis/) [Healthcare](/templates/industry/healthcare/)[Mental Health](/templates/industry/mental-health/) [Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/)[Medical Assistant](/templates/role/medical-assistant/)[EMT & Paramedic](/templates/role/emt-paramedic/)     About this free form template
### Emergency Room Post-Shift Wellness Check Form Template

Emergency room healthcare workers face some of the most challenging and emotionally demanding situations in medicine. From trauma cases and violent incidents to high-stress decision-making and patient loss, ER staff are regularly exposed to circumstances that can take a significant toll on mental health and well-being.

This **Emergency Room Staff Post-Shift Wellness Check** form template is designed to provide healthcare facilities with a structured, confidential way to monitor staff well-being, identify those who may need additional support, and connect team members with peer debriefing and mental health resources.

#### Why ER Staff Wellness Checks Matter

Healthcare worker burnout, compassion fatigue, and PTSD are serious concerns in emergency medicine. Regular wellness checks help organizations:

 - **Identify staff members who need immediate support** after particularly difficult shifts
 - **Track patterns of trauma exposure and violence** to improve safety protocols
 - **Reduce burnout and turnover** by demonstrating genuine care for staff well-being
 - **Create a culture of psychological safety** where asking for help is normalized
 - **Connect staff with peer support and debriefing** before issues escalate
 - **Comply with workplace safety and mental health regulations**

#### How This Wellness Check Form Works

This template includes carefully designed questions that assess:

 - **Shift details and basic information** to provide context
 - **Trauma exposure levels** during the shift (critical cases, deaths, pediatric trauma)
 - **Violence and aggression incidents** from patients or visitors
 - **Emotional exhaustion and stress indicators** using validated wellness metrics
 - **Physical safety concerns** and workplace hazards
 - **Need for peer debriefing or counseling** with immediate connection to resources
 - **Confidential open feedback** for staff to share concerns

The form uses conditional logic to route staff experiencing high distress directly to support resources, while maintaining confidentiality and removing barriers to seeking help.

#### Perfect for Healthcare Facilities and Emergency Departments

This wellness check form is ideal for:

 - **Hospital emergency departments** monitoring staff mental health
 - **Urgent care centers** supporting frontline workers
 - **Trauma centers** with high-acuity patient populations
 - **Behavioral health emergency services** dealing with psychiatric crises
 - **Pediatric emergency departments** where staff face unique emotional challenges
 - **Rural and understaffed ERs** where burnout risk is elevated

#### Customizable for Your Healthcare Environment

While this template is specifically designed for emergency room settings, you can easily customize it with Paperform's intuitive editor to match your facility's needs:

 - **Add facility-specific incident categories** relevant to your ER
 - **Integrate with your employee assistance program (EAP)** or mental health resources
 - **Customize debriefing protocols** based on your peer support structure
 - **Include anonymous submission options** to encourage honest reporting
 - **Add follow-up workflows** to ensure staff receive timely support

#### Automate Wellness Check Workflows with Stepper

After a staff member completes their wellness check, you can use [Stepper](https://stepper.io) to automatically:

 - **Route high-concern responses** to your employee assistance coordinator
 - **Schedule peer debriefing sessions** with trained staff supporters
 - **Send wellness resources** via email based on specific concerns indicated
 - **Log incidents** in your safety management system
 - **Notify department leadership** (while maintaining confidentiality) about trends
 - **Create follow-up tasks** in project management tools to ensure staff receive support

This automation ensures no wellness check falls through the cracks and staff receive timely support without overburdening leadership.

#### Built with Paperform: Professional, Confidential, Compliant

Paperform provides healthcare organizations with the security and compliance features essential for staff wellness monitoring:

 - **SOC 2 Type II certified** for data security
 - **GDPR compliant** with strong privacy controls
 - **Anonymous submission options** to protect staff privacy
 - **Conditional logic** to route high-risk responses to appropriate resources
 - **Secure integrations** with HR systems and employee assistance programs
 - **Custom success pages** that immediately connect staff with support resources

#### Supporting Your Healthcare Heroes

Emergency room staff give everything to care for patients in crisis—they deserve an organization that cares for them in return. This post-shift wellness check creates a simple, confidential touchpoint that demonstrates your commitment to staff mental health while providing actionable data to improve workplace well-being.

Whether you're implementing a new staff support program or improving existing wellness initiatives, this Paperform template gives you a professional, compassionate tool that meets staff where they are and connects them with the help they need.

Start using this template today to build a culture of care that extends to your entire healthcare team—because taking care of your staff means they can continue taking care of your patients.
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