We can CERTainly prepare for a disaster.

CERT Forms

CERT Forms

All Forms Bundle
All-Forms-2011.pdf

1. Damage Assessment
Completed by CERT members as they travel through the area to the CERT staging location, then given to the CERT IC/TL; provides a summary of overall hazards in selected areas, including:

  • Fires

  • Utility hazards

  • Structural damage

  • Injuries and casualties

  • Available access

Essential for prioritizing and formulating action plans.
Damage-Assessment-2011.pdf
Formulario-de-Evaluación-de-Los-Daños-2011.pdf

2. Personnel Resources
Used to sign in CERT members as they arrive at the staging location; provides information about:

  • Who is on site

  • When they arrived

  • When they were assigned

  • Their special skills

Used by staging personnel to track personnel availability
Personnel-Resources-2011.pdf
Registro-de-Recursos-Humanos-2011.pdf

3. Incident/Assignment Tracking Log
Used by the Command Post for keeping abreast of situation status; contains essential information for tracking the overall situation
Assignment-Tracking-Log-2011.pdf
Diarios-de-Seguimiento-de-Tareas-2011.pdf

4a-4b. Briefing Assignment
Used by the Command Post to provide instructions to functional teams; used by teams to log their actions and report new damage assessment information
Briefing-Assignment-2011.pdf
Instrucciones-Sobre-las-Tareas-2011.pdf

5. Victim Treatment Area Record
Completed by medical treatment area personnel to record victims entering the treatment area, their condition, and their status
Victim-Treatment-Area-Record-2011.pdf
Registro-del-Área-de-Tratamiento-de-Víctimas-2011.pdf

6. Communications Log
Completed by the radio operator; used to log incoming and outgoing transmissions
Communications-Log-2011.pdf
Registro-de-Comunicaciones-2011.pdf

7. Equipment Inventory
Used to check out and check in CERT-managed equipment
Equipment-Inventory-2011.pdf
Inventario-del-Equipo-2011.pdf

8. General Message
Used for sending messages between command levels and groups; messages should be clear and concise and should focus on such key issues as:

  • Assignment completion

  • Additional resources required

  • Special information

  • Status update

General-Message-2011.pdf
Mensaje-General-2011.pdf

Volunteer Enrollment Form
This is a form required citywide for all volunteers. It is required for many of our events. It is not an enrollment form for CERT. If you do not have a form on file, print it, fill it out and email to XXX.
Volunteer-Enrollment-Form.pdf - This is the LA CERT form. Richmond’s coming soon…

ICS 214
Used by the Command Post to records details of notable activities at any ICS level, including single resources, equipment, Task Forces, etc. These logs provide basic incident activity documentation, and a reference for any after action report.
ICS-214.pdf

CERT & ISC FORMS

CERT Form 1 - Damage Assessment
CERT Form 1a - Damage Assessment Summary
CERT Form 2 - Personnel Resources - Check-In
CERT Form 3 - Assignment Tracking Log

CERT Form 4 - Briefing Assignment
CERT Form 5 - Victim Treatment Area Record
CERT Form 6 - ICS-309 Communications Log
CERT Form 7 - ICS-303 Equipment Inventory
CERT Form 8 - ICS-213 General Message
ICS-213 Message Flowchart
ICS-214 Activity Log
Incident Commander Checklist