HICS205A - COMMUNICATIONS LIST 
HICS - Hospital Incident Command System
   1. Incident Name:     {var Incident_Name}  

        Facility: {var Facility}

        Page  {var Page}  of   {var Page1}  

   2. Operational Period    (#):  {var OpNum}
         
Date From:  
{var DateFrom}
 to
 {var DateTo}
Time From:  
{var TimeFrom}
 to
{var TimeTo}

   3. Contact List Type: {var ContactType}

 Assignment / Name   Radio Ch #
Frequency
Telephone  Fax  Email  Moble Phone  Pager
 ID # of Device Issued
& Comments
 {var Assignment1}
{var Ch1}
{var Phone1}
{var Fax1}
{var Email1}
{var Mobil1}
{var Pager1}
{var Id1}
 {var Assignment2}
{var Ch2}
{var Phone2}
{var Fax2}
{var Email2}
{var Mobil2}
{var Pager2}
{var Id2}
 {var Assignment3}
{var Ch3}
{var Phone3}
{var Fax3}
{var Email3}
{var Mobil3}
{var Pager3}
{var Id3}
 {var Assignment4}
{var Ch4}
{var Phone4}
{var Fax4}
{var Email4}
{var Mobil4}
{var Pager4}
{var Id4}
 {var Assignment5}
{var Ch5}
{var Phone5}
{var Fax5}
{var Email5}
{var Mobil5}
{var Pager5}
{var Id5}
 {var Assignment6}
{var Ch6}
{var Phone6}
{var Fax6}
{var Email6}
{var Mobil6}
{var Pager6}
{var Id6}
 {var Assignment7}
{var Ch7}
{var Phone7}
{var Fax7}
{var Email7}
{var Mobil7}
{var Pager7}
{var Id7}
 {var Assignment8}
{var Ch8}
{var Phone8}
{var Fax8}
{var Email8}
{var Mobil8}
{var Pager8}
{var Id8}
 {var Assignment9}
{var Ch9}
{var Phone9}
{var Fax9}
{var Email9}
{var Mobil9}
{var Pager9}
{var Id9}
 {var Assignment10}
{var Ch10}
{var Phone10}
{var Fax10}
{var Email10}
{var Mobil10}
{var Pager10}
{var Id10}
 {var Assignment11}
{var Ch11}
{var Phone11}
{var Fax11}
{var Email11}
{var Mobil11}
{var Pager11}
{var Id11}
 {var Assignment12}
{var Ch12}
{var Phone12}
{var Fax12}
{var Email12}
{var Mobil12}
{var Pager12}
{var Id12}
 
{var Assignment13}
{var Ch13}
{var Phone13}
{var Fax13}
{var Email13}
{var Mobil13}
{var Pager13}
{var Id13}
 {var Assignment14}
{var Ch14}
{var Phone14}
{var Fax14}
{var Email14}
{var Mobil14}
{var Pager14}
{var Id14}
 {var Assignment15}
{var Ch15}
{var Phone15}
{var Fax15}
{var Email15}
{var Mobil15}
{var Pager15}
{var Id15}

   4. Special Instructions

   {var specialInstructions}


5. Prepared by (CUL):   {var PreparedName}       {var Date_Time}  {var Time}  

  {var Templateversion}             Winlink Station Sending  {var MsgSender}