HEF

EMS Resource Form

EMS Agency Name(Required)

Evaluator name(Required)

First Last

Evaluator email(Required)

1. Within 15 minutes of the notification to active the EOC, how many staff members responded with their availability to report?(Required)

2a. Within 30 minutes of the “all-hands” alert for county fire departments, how many departments reported to the EOC?(Required)

2b. Within 30 minutes of the “all-hands” alert for county fire departments, what resources was the department able to offer. (If you do not have a fire Dept with your agency or playing in the exercise, type NA in the text box)(Required)

2c. Within 30 minutes of the “all-hands” alert for county fire departments, how many staff members were available? (If no fire Dept. mark NA)(Required)

3a. How many units (ALS and BLS total) did you have staffed to respond to this emergency?(Required)

3b. How many units were in service?(Required)

3c. Upon notification, how long did it take your agency to quantify your resource availability and current utilization. (Ambulances available vs. In-Service)(Required)

4. How long (on average throughout the exercise) did it take your agency to accurately triage and allocate the appropriate resource for the requested patient transfer?(Required)

How many Aeromedical helicopters did you have available to support the exercise?(Required)