TBHMPC Training & Exercise Resource Request Form

Please complete all fields of the below form to request check-out of Coalition training & exercise resources. A staff member will reach out to coordinate pick-up details. Resources may be picked up at the TBHMPC office at 7300 Bryan Dairy Road, Suite 450, Largo, FL 33777. In certain circumstances, other pickup/delivery arrangements may be made.

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1. Name:

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2. Organization Name:

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3. Email Address:

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4. Contact Phone Number:

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5. Resources Requested:

Disasters in Seconds Pediatric Patients Simulation Kit

Disasters in Seconds Adult Patients Simulation Kit

Basic Tabletop Training Essentials Kit

Enhanced Blast Injury Tabletop Training Kit

Evac123 Tabletop Training Kit

SRS Surge Tabletop Training Kit for Hospitals

Victim Cards - Standard Adult, Set of 32

Victim Cards - Standard Pediatric, Set of 32

Mini Treatment Area Tarps, Set of 4

Active Shooter Victim Card Deck, Set of 32

Backdoors & Breaches Incident Response Card Game (Info Security)

START Triage Training Wheels

STOP THE BLEED Training Kit

TBHMPC Training & Exercise Resource Request Form

Question Title

* 1. Name:

Question Title

* 2. Organization Name:

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* 3. Email Address:

Question Title

* 4. Contact Phone Number:

Question Title

* 5. Resources Requested:

Question Title

* 6. Date Resource is Needed By:

1. Name:

2. Organization Name:

3. Email Address:

4. Contact Phone Number:

5. Resources Requested:

6. Date Resource is Needed By: