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Part I – Exercise Participation Feedback

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* 1. Name of the Organization you are representing

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* 2. Where did you participate in the exercise?

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* 3. What were your top three functions/tasks for your role?

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* 4. Were you able to accomplish your functions/tasks during the exercise?

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* 5. Do you feel that you had adequate communications during the exercise?

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* 6. What are your suggestions to improve flow of information, if any?

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* 7. What are your suggestions to improve coordination, if any?

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* 8. Did you have ICS training to prepare you for your role?

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* 9. If yes, did the ICS training help you understand how all roles function together? If no, please provide additional information.

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* 10. Were you able to identify ways for your organization/facility to improve one or more parts of their plans?

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* 11. For Hospitals and LTCFs: Were you able to effectively exercise medical surge expansion?

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* 12. Were you able to effectively test infection control at your facility?

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* 13. Briefly describe the 1 or 2 strengths demonstrated by your facility for any of the exercise objectives.

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* 14. Please briefly describe 1 or 2 challenges or weaknesses you observed by your facility for any of the exercise objectives.

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* 15. List and briefly describe elements to address for future exercises.

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