HICS - 203 ORGANIZATIONAL ASSIGNMENT LIST

 1. Incident Name  

     {var Incidentname}

 2. Operational Period    (# {var opperiod} )
Date From:
{var DateFrom}
Date To:
{var DateTo}
Time From:
{var TimeFrom}
Time To:
{var TimeTo}
POSITION
NAME
CONTACT INFO (PHONE, CELL, RADIO)
3. Incident Commander(s) and Staff
    Incident Commander {var A1} {var B1}
    Public Information Officer {var A2} {var B2}
    Liaison Officer {var A3} {var B3}
    Safety Officer {var A4} {var B4}
    Medical-Technical Specialist: {var A5} {var B5}
    Medical-Technical Specialist: {var A6} {var B6}
    Medical-Technical Specialist: {var A7} {var B7}
    Medical-Technical Specialist: {var A8} {var B8}
4. Operations Section
    Operations Chief {var A10} {var B10}
    Staging Manager {var A11} {var B11}
    Medical Care Branch Director {var A12} {var B12}
    Infrastructure Branch Director {var A13} {var B13}
    Security Branch Director {var A14} {var B14}
    Hazardous Materials Branch Director {var A15} {var B15}
    Business Continuity Branch Director {var A16} {var B16}
    Patient Family Assistance Director {var A17} {var B17}
    Others if needed {var A18} {var A18}
5. Planning Section
    Planning Chief {var A20} {var B20}
    Resources Unit Leader {var A21} {var B21}
    Situation Unit Leader {var A22} {var B22}
    Documentation Unit Leader {var A23} {var B23}
    Demobilization Unit Leader {var A24} {var B24}
6. Logistics Sections
    Logistics Chief {var A26} {var B26}
    Service Branch Director {var A27} {var B27}
    Support Branch Director {var A28} {var B28}
7. Finance / Administration Section
    Finance/Administration Chief {var A30} {var B30}
    Time Unit Leader {var A31} {var B31}
    Procurement Unit Leader {var A32} {var B32}
    Compensation/Claims Unit Leader {var A33} {var B33}
    Cost Unit Leader {var A34} {var B34}
8. Agency Executive {var A35} {var B35}
9. External Agency Representative
    (in the Hospital Command Center)
{var A36} {var B36}
10. Hospital Representative (in the external
       Emergency Operations Center)
{var A37} {var B37}
Additional information/notes
{var Information}

 9. Prepared by: Name: {var PreparedBY}       Position/ Title: {var Prepartitle}        Date/Time: {var PreparedDate}

       Facility: {var Facility}

       IAP Page: {var IAPage}    

{var Templateversion}