Thursday, September 08, 2005, 13:15 EDT (1:15 PM EDT)
CDCHAN-00234-2005-09-08-ADV-N
Medical Intake Form for Hurricane Katrina Evacuees
This interim form is intended to be used for medical intake assessment and triage of evacuees entering a shelter facility or evacuation center. The form can be used to identify evacuees who may need additional medical evaluation and treatment. The first page contains registration information for use by facility, local, and state authorities. The remaining pages can be used to anonymously report medical conditions among evacuees.
The form is available online at http://www.bt.cdc.gov/disasters/hurricanes/katrina/evacueeform.asp
HAN Message Types
- Health Alert: Conveys the highest level of importance; warrants immediate action or attention. Example: HAN00001
- Health Advisory: Provides important information for a specific incident or situation; may not require immediate action. Example: HAN00316
- Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action. Example: HAN00309
- Info Service: Provides general information that is not necessarily considered to be of an emergent nature. Example: HAN00319
## This Message was distributed to State and Local Health Officers, Public Information Officers, Epidemiologists and HAN Coordinators as well as Clinician organizations ##
You have received this message based upon the information contained within our emergency notification database. If you have a different or additional e-mail or fax address that you would like us to use, please contact your State-based Health Alert Network program at your State or local health department.
- Page last reviewed: April 29, 2011 5:00 PM ET
- Page last updated: April 29, 2011 5:00 PM ET
- Content source: CDC Emergency Risk Communication Branch (ERCB), Division of Emergency Operations (DEO), Office of Public Health Preparedness and Response (OPHPR)
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