NJ EMS Task Force - Incident Management Team - EMS MACC
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PAPEL VISIT 2015
Report Local Event
Use this form to report a local event that may be occurring anywhere in NJ during the period of September 20 through September 30, 2015.
*
Indicates required field
Reporting Person
*
First
Last
Title/Agency
*
Phone Number
*
Email
*
Select One
*
select one
Popal Visit Related
World Family Related
Non-Related Event
Name of Event
*
Date(s) & Time(s)
*
Location(s)
*
County(ies) affected
*
Estimated Number Attendees
*
EMS Resources ASSIGNED
*
List any local or mutual aid resources you will be using for this event. Be specific in the resource, name, type, etc.
EMS Resources NEEDED
*
Enter any EMS Resources you are requesting assistance in locating to cover this event.
Comment - Include Risk of Escalation of Event
*
Submit
After Action Survey - NJ PAPAL DEPLOYMENT