HEF

Emergency Management Resource Form

Agency Name(Required)

Evaluator Name(Required)

First Last

1. How long did it take your agency to notify all relevant agencies (not first responders, but EPA, EMD etc) of an emergency event upon initial notification of the event.(Required)

2. Did your agency post in WebEOC on the Significant events board?(Required)

4. How many of your staff responded to the initial notification within 30 minutes by giving a list of available resources, including staff?(Required)

3. How many staff members responded within 15 minutes of the initial notification, by giving their available status?(Required)

5. Did your agency receive a call from a dialysis center requesting a vehicle (bus, van etc.) to transport hemodialysis patients to and/or from their facility for treatment?(Required)