ICS-209 NJ SEOC Input Form - New Jersey EMS Task Force Incident Management Team - EMS MACC

New Jersey EMS Task Force Incident Management Team - EMS MACC

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ICS-209 NJ SEOC ESF8 EMS Input Form

This form is used to submit data to the NJ SEOC Desk from NJ County EMS Coordinators and other allied partners

ICS-209 NJ SEOC ESF8 EMS SitRep Input

* Indicates required field

Name *

First

Last

County/Region *

Email *

Phone Number *

Status of BLS Staffing in your jurisdiction *

Well below normal Below normal Normal Above Normal Well Above Normal Unknown

Status of ALS Staffing in your jusrisdiction *

Well below normal Below Normal Normal Above Normal Well above normal Unknown

EMS Call Volume *

Well below normal Below normal Normal Above normal Well above normal Unknown

General Response Times *

Normal Extended Severely Extended Unknown

Specialty EMS Resources in use (i.e. EMSTF resources, Off-Road Ambulance Vehicles such as gators, ASAPs, etc). *

Any Specialty EMS Resources OUT OF SERVICE and REASON (make sure to report NJEMSTF assets in mobile reporter as well) *

Any EMS Jurisdictional Agencies OUT OF SERVICE and REASON *

Operational/Dispatch Communications for EMS Status *

Normal Operating Remotely Overloaded On Backup/Manual procedures Unknown

Any other relevant information *

Submit to ESF8 Desk

Telephone

1-973-878-9911

eFax

1-302-340-6881

Email

[email protected]

After Action Survey - NJ PAPAL DEPLOYMENT