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HICS 206 – STAFF MEDICAL PLAN
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1. INCIDENT NAME
206 incident
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2. DATE PREPARED
2011-11-01
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3. TIME PREPARED
0749L
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4. OPERATIONAL PERIOD DATE/TIME
til the twelfth of never
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5. TREATMENT OF INJURED / STAFF
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Location of Staff Treatment Area
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Contact Information
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Treatment Area Team Leader
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Contact Information
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Special Instructions
be kind and gentle
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| 6. RESOURCES ON HAND |
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STAFF
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MEDICAL TRANSPORTATION
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MEDICATION
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SUPPLIES
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| MD/DO: |
Litters: |
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| PA/NP: |
Portable |
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| RN/LPN: |
Transport: |
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| Technicians/CN: |
Wheelchairs: |
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| Ancillary/Other: |
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| 7. ALTERNATE CARE SITE(S) |
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ADDRESS |
PHONE |
SPECIALTY CARE |
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8. PREPARED BY (SUPPORT BRANCH DIRECTOR): dave
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9. FACILITY NAME whitfield
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