NJ EMS Task Force - Incident Management Team - EMS MACC
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STAGING MODULE
County EMS COORDINATORS can use this form to request a change or addition to a designated staging area. Please complete ALL items.
Staging Area Change/Addition Request Form
*
Indicates required field
Person Making Request
*
First
Last
Email
*
County of Staging Area
*
Change or Add?
*
CHANGE
ADDITION
DELETION
Location of Staging Area (Name, Address, Zip, info)
*
Ingress & Egress Route Instructions:
*
Frequencies Utilized:
*
Bathroom/Shelter Info:
*
Site Security Provided By:
*
Site Security Contact Info:
*
Activation Process (Include regional/local dispatch center, name, phone number and directions)
*
Submit
After Action Survey - NJ PAPAL DEPLOYMENT