Templates for the Public Health Emergency Response Guide for State, Local, and Tribal Public Health Directors
Languages
- Español (Spanish)
| Template | Microsoft Word  (can be filled out on computer and/or printed out) |
PDF  (can be printed out) |
||
|---|---|---|---|---|
| English | Spanish |
English | Spanish |
|
| Template 1. Documentation of Contacts and Actions Allows for the documentation of contacts and activities during the response to an incident. |
195 KB/3 pages | 155 KB/4 pages | 47 KB/3 pages | 161 KB/4 pages |
| Template 2. Health Department Personnel Emergency Contact Information Allows for the listing of contact information for key personnel within your health department. It should be completed by the user prior to an incident. |
163 KB/2 pages | 103 KB/2 pages | 39 KB/2 pages | 123 KB/2 pages |
| Template 3. State, Local, and Tribal Emergency Contact Information Allows for the listing of contact information for state, local, and tribal response partners within your community. It should be completed by the user prior to an incident. |
158 KB/2 pages | 102 KB/2 pages | 39 KB/2 pages | 123 KB/2 pages |
| Template 4. Leadership Assignments Allows for the documentation of public health leadership assignments during the response to an incident. |
219 KB/4 pages | 171 KB/7 pages | 84 KB/4 pages | 197 KB/7 pages |
| Template 5. Incident-Specific Public Health Preparedness Enables health departments to rank their level of preparedness to respond to specific types of incidents. |
206 KB/4 pages | 220 KB/9 pages | 81 KB/4 pages | 277 KB/9 pages |
Page last modified January 13, 2006
Page last reviewed October 2, 2007