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Please report by 3pm, tomorrow, Sat, June 4, 2011.

Hospital and Community Health Centers in Regions 1 and 2:

To assist MEMA with its information gathering as part of the Commonwealth’s application for a Presidential Disaster Declaration (and the FEMA disaster relief funds which come with such a declaration), the Emergency Preparedness Bureau requests you respond to the following brief survey.

Please coordinate amongst staff members at your institution who receive HHAN alerts so that EPB receives only one response on behalf of your hospital or health center.

If you have any questions or concerns, please call me at 617-217-8252.

Thanks,
Timothy

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* 1. Facility Name:

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* 2. Facility Point of Contact (POC):

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* 3. POC Phone Number (cell phone please):

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* 4. POC Email Address:

Please take some time to do a brief internal assessment of patients that have presented at your hospital or health center over the last 48+ hours, and then please enter the number of patients that have presented at your facility fo medical resulting from the tornadoes and violent thunderstorms that occurred in Massachusetts on June 1, 2011.

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* 5. Number of presenting patients:

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