Kings County Healthcare Emergency Preparedness Committee - Medical Health Flash Report

Medical Health Situation Report

All healthcare facilities located in Kings County should submit a Situation Report (SitRep) to the MHOAC Program, for any unusual (an event that is not day-to-day/routine) or emergency event and when requested by the MHOAC. It is expected that you submit a report within one (1) hour of a MHOAC request.

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* 1. Report Type

Initial

Update

Final

Drill/Exercise

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* 2. Report Status

Advisory: No Action Required

Alert: Action Required - See Below

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* 3. Date and Time

Date/Time of Report

Date

Time

AM/PM

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* 4. Name/Position

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* 5. Agency

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* 6. Email

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* 7. Phone Number

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* 8. Prognosis

No Change

Improving

Worsening

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* 9. Current Situation

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* 10. Current Priorities/Critical Issues

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* 11. Actions Taken

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* 12. Are you requesting resources? If resources are being requested, you must submit a resource request.

Yes