FORMS

HCEM CERT FORMS

Command Post

Command.jpg

Used to sign in CERT members as they arrive at the staging location; provides information about:

  • Who is on site

  • When they arrived

  • When they were assigned

  • Their special skills

Personnel Resources Check-in
signin.jpg
Assignment Tracking Log

Used by the Command Post for keeping abreast of situation status; contains essential information for tracking the overall situation

ATL.jpg
Victims & Locations

Used by the Command Post for capturing data from SAR. Data captured: # of victims, status of victum, adult, teen or child, and location status.

Victim_Locations.jpg


Used to check out and check in CERT-managed equipment

Equipment Inventory
Equipment.jpg

Completed by the radio operator; used to log incoming and outgoing transmissions

Communications Log
CommLog.jpg

Used to sign in spontaneous unaffiliated volunteers as they arrive at the staging location; provides information about:

  • Who is on site

  • When they arrived

  • When they were assigned

  • Their special skills

Volunteer Resources Check-in
signin.jpg

Used by the Command Post to provide instructions to functional teams. Used to recognize potential incident Health and Safety Hazards and develop necessary measures to protect responders from those hazards.

Incident Briefing
IncidentBriefing.jpg

Medical Treatment Area

treatment.jfif
Medical Treatment Area Log

Completed by medical treatment area personnel to record victims entering the treatment area, their condition, and their status

MTA.jpg

Search & Rescue

SAR.jfif
 Damage Briefing Summary

Used by the Command Post to provide instructions to functional teams; used by teams to log their actions and report new damage assessment information

briefing.jpg
 Damage Assessment Form

Completed by CERT members as they travel through the area to the CERT staging location, then given to the CERT IC/TL; provides a summary of overall hazards in selected areas, including:

 

  • Fires

  • Utility hazards

  • Structural damage

  • Injuries and casualties

  • Available access

DamageAssessment.jpg
4 W's

Completed by CERT members as they travel through the area assessing the location asking"

 

  • What happened?

  • Where did it happen?

  • When did it happen?

  • Who did it happen to?

5W.jpg