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1. Demographic Questions

Thank you for taking this survey. We appreciate your efforts to move Arizona's healthcare preparedness forward.

Your Role:
The first part of this survey invites you to review all hazards and provide your opinion of the potential impact of each on healthcare services. The second part of the survey will ask you to report out on your facility/organizational resources and plans. The survey should take approximately 30 minutes to complete, but you might need to gather information from other departments before beginning. 

The regional and statewide Community Hazard Vulnerability and Resource assessments will be completed and shared with AzCHER members and partners in January 2023. The assessments will assist organizations and facilities in creating site-specific HVAs and guide AzCHER plans, trainings, and exercises over the next five years to address top hazards and identify gaps in the system to address these hazards.

Please note that you can return to this survey and pick up where you left off to edit your responses any time before November 23 at 5:00pm. You may make edits to previous responses, even after you have submitted them, up until the close date.
Note: if you submit information for multiple facilities, you will need to use separate IP addresses (i.e. use different browsers or computer).

If you have any questions, please contact Shawna Murphy at smurphy@azhha.org or Brianna Rooney at brooney@azhha.org.

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* 1. Name:

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* 2. Email:

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* 3. Organization Name:

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* 4. Facility Name:

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* 5. What is your facility/organization/agency or member type? Choose one (1) option that best fits.

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* 6. In which county or tribe is your facility/organization/agency located?

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