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4. MAP SKETCH
PAGE 2
ICS 201
7. CURRENT ORGANIZATION
PAGE 3
ICS 201
8. RESOURCE SUMMARY
Resources Ordered Resources Identification ETA On Scene Local Assignment
PAGE 4
ICS 201
ORGANIZATIONAL ASSIGNMENT LIST, ICS FORM 203
PREPARED BY:
MEDICAL PLAN
ICS 206
1. INCIDENT/EVENT NAME 2. OPERATIONAL PERIOD
From (Date and Time):
To (Date and Time):
3. MEDICAL AID STATIONS
With
Contact Remarks
Name Location Contact Person Paramedics?
Number(s)
Yes No
5. HOSPITALS
With
Travel With Burn With
Contact Contact Trauma
Name Location Time Center? Helipad?
Person Number(s) Center?
Air Land Yes No Yes No Yes No
__ Check if aviation assets are utilized for rescue. If assets are used, coordinate with Air Operation Branch
6. LOGISTICS SECTION
Chief
Deputy
SUPPORT BRANCH
Director
Supply Unit
Facilities Unit 8. FINANCE/ADMINISTRATIVE SECTION
Ground Support Unit Chief
SERVICE BRANCH Deputy
Director Time Unit
Communications Unit Procurement Unit
Medical Unit Compensation/Claims Unit
Food Unit Cost Unit
9. Prepared by RESL Name and Signature: Date Prepared: Time Prepared:
ASSIGNMENT LIST
ICS 204
1. INCIDENT/EVENT NAME 2. OPERATIONAL PERIOD 3. BRANCH:
From(Date and Time): Group:
Division:
To (Date and Time): Staging Area:
4. OPERATIONS PERSONNEL
Position Name Agency/office Contact number(s)
Operation Sector Chief
Branch Director
Staging Area Manager
Division Group Supervisor
Air/Water Tactical Group
Supervisor