HICS 203 – ORGANIZATION ASSIGNMENT LIST

 

1.  INCIDENT NAME

2.   DATE PREPARED

3.  TIME PREPARED

4.  OPERATIONAL PERIOD DATE/TIME

 :inc:

 :dat:

 :tim:

 :opp:

POSITION

NAME / AGENCY

5.  Incident Commander and Staff

Incident Commander

 :icc:

Public Information Officer

 :ici:

Liaison Officer

 :icl:

Safety Officer

 :ics:

Medical/Technical Specialist (Type)

 :tech_spc[0]:

Medical/Technical Specialist (Type)

 :tech_spc[1]:

Medical/Technical Specialist (Type)

 :tech_spc[2]:

Medical/Technical Specialist (Type)

 :tech_spc[3]:

Medical/Technical Specialist (Type)

 :tech_spc[4]:

Medical/Technical Specialist (Type)

 :tech_spc[5]:

6.  Operations Section

Chief

 :ops_chief:

Staging Manager

 :stg_mgr:

Medical Care Branch

 :med_care_brch:

Infrastructure Branch

 :infr_brch:

Security Branch

 :sec_brch:

Business Continuity Branch

 :bus_brch:

HazMat Branch

 :hazmat_brch:

Other Branch:

 :ops_other:

7.  Planning Section

Chief

 :planning_chief:

Resources Unit

 :res_unit:

Situation Unit

 :sit_unit:

Documentation Unit

 :doc_unit:

Demobilization Unit

 :dem_unit:

Other Branch:

 :planning_other:

8.  Logistics Section

Chief

 :log_chief:

Service Branch

 :svc_brch:

Support Branch

 :sup_brch:

Other Branch:

 :log_other:

9.  Finance/Administration Section

Chief

 :fin_chief:

Time Unit

 :time_unit:

Procurement Unit

 :proc_unit:

Compensation/Claims Unit

 :comp_unit:

Cost Unit

 :cost_unit:

Other Branch:

 :fin_other:

10.  Agency Representative (in Hospital Command Center)

Agency

 :hcc_agency:

 :hcc_rep:

 

 

 

11.  Hospital Representative (in External EOC)

External Location

 :ext_loc:

 :ext_rep:

 

 

 

 

12. PREPARED BY (RESOURCES UNIT LEADER) :pre:

13. FACILITY NAME :facility: