HICS 201 INCIDENT BRIEFING
                 HICS - Hospital Incident Command System  

   1. Incident Name

      {var Incident_Name}

     
   2. Operational Period     (#):   {var OpNum}

         Date From      To  

         Time From         To  

   3.Situation Summary (for briefings or transfer of command)
  {var SitSummary}


   4.Health and Safety Briefing
Identify potential incident health and safety hazards and implement necessary measures (remove hazard, provide personal protective equipment, warn people of the hazard) to protect responders from those hazards. (Summary of HICS 215A)

  {var HealthBriefing}


   5. Map/Sketch (include sketch, showing the total area of operations, the incident site/area, impacted and threatened areas, overflight results, trajectories, impacted shorelines, or other graphics depicting situational status and resource assignment as needed.):

JPEG map/sketch attached {var MapAttached}


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                   HICS 201 INCIDENT BRIEFING
        


    6. Current Hospital Management Team (fill in additional positions as appropiate)

PIO
 

Incident Commander

 
Medical Technical Specialist
     
Liasion Office
     
Medical Technical Specialist
     
Safety Officer
     
Medical Technical Specialist

 
 
Operations
Section Chief

 
Planning
Section Chief

 
Logistics
Planning Chief

 
Finance / Administration
Section Chief

Staging Manager
 Resources Unit Leader
Service Branch Director
Time Unit Leader

 
Medical Care Branch Director
 
Situation Unit Leader
 
Support Branch Director

 
Procurement Unit Leader
 
Infrastructure Branch Director
 
Documentation Unit Leader
     
Compensation/Claims Unit Leader
 
Security Branch Director

 
Demobilization Unit Leader
     
Cost Unit Leader

 
HazMat Branch Director

           
 
Business Continuity Branch Director
           
 
Patient Family Assistance Director

           
 
Other (if needed)
           



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     7. Incident Objectives
   {var IncObjective}
    8. Summary of Current and Planned Actions

 TIME  ACTIVITY
HICS 201 | Page 3 of 4  


    9. Summary of Resources Requested and Assigned

RESOURCE DATE / TIME
ORDERED
ETA DATE / TIME
ARRIVED
NOTES
(LOCATION / ASSIGNMENT / STATUS)
{var Resource1} {var OrderT1} {var ETA1} {var ArriveT1} {var ResNotes1}
{var Resource2} {var OrderT2} {var ETA2} {var ArriveT2} {var ResNotes2}
{var Resource3} {var OrderT3} {var ETA3} {var ArriveT3} {var ResNotes3}
{var Resource4} {var OrderT4} {var ETA4} {var ArriveT4} {var ResNotes4}
{var Resource5} {var OrderT5} {var ETA5} {var ArriveT5} {var ResNotes5}
{var Resource6} {var OrderT6} {var ETA6} {var ArriveT6} {var ResNotes6}
{var Resource7} {var OrderT7} {var ETA7} {var ArriveT7} {var ResNotes7}
{var Resource8} {var OrderT8} {var ETA8} {var ArriveT8} {var ResNotes8}
{var Resource9} {var OrderT9} {var ETA9} {var ArriveT9} {var ResNotes9}
{var Resource10} {var OrderT10} {var ETA10} {var ArriveT10} {var ResNotes10}
{var Resource11} {var OrderT11} {var ETA11} {var ArriveT11} {var ResNotes11}
{var Resource12} {var OrderT12} {var ETA12} {var ArriveT12} {var ResNotes12}
{var Resource13} {var OrderT13} {var ETA13} {var ArriveT13} {var ResNotes13}
{var Resource14} {var OrderT14} {var ETA14} {var ArriveT14} {var ResNotes14}
{var Resource15} {var OrderT15} {var ETA15} {var ArriveT15} {var ResNotes15}


    10. Prepared by: Name: {var Prepedby}     Position/Title: {var Position}    Signature: {var Prepsig}

    Date/Time: {var prepDateTime}

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