HICS 206 – STAFF MEDICAL PLAN
1. INCIDENT NAME
206 incident
2. DATE PREPARED
2011-11-01
3. TIME PREPARED
0749L
4. OPERATIONAL PERIOD DATE/TIME
til the twelfth of never
5. TREATMENT OF INJURED / STAFF
Location of Staff Treatment Area

Contact Information

Treatment Area Team Leader

Contact Information

Special Instructions
be kind and gentle
6. RESOURCES ON HAND
STAFF MEDICAL TRANSPORTATION MEDICATION SUPPLIES
MD/DO: Litters:
PA/NP: Portable
RN/LPN: Transport:
Technicians/CN: Wheelchairs:
Ancillary/Other:
7. ALTERNATE CARE SITE(S)
NAME ADDRESS PHONE SPECIALTY CARE




8. PREPARED BY (SUPPORT BRANCH DIRECTOR): dave
9. FACILITY NAME whitfield