CERT Forms

These are current versions of forms used by Lamorinda CERT members during an emergency. All members should print these forms and maintain a small supply of them in their backpack.

Evacuation Tips – Steps to take before a disaster and during a disaster. Focused on wildfire but applicable to earthquake and other disasters also.

Documentation Worksheet – A worksheet for gathering documents to scan for your go-bag. Having these documents scanned will make recovery from a disaster much easier.

Unaccompanied Minor Checklist – instructions to keep the subject, yourself and CERT safe when you find an unaccompanied minor or AFN adult following a disaster.

Unaccompanied Minor Report Form and Instructions – Use this form and instruction sheet if you find either an Unaccompanied Minor or a Separated Child.

Message Form – this is 2 on. After printing, cut the sheet in half.

Damage Assessment – used in the field by each team – deprecated 02/07/2014 – use Rapid Needs Assessment form instead

Rapid Needs Assessment – Form to be used immediately following a disaster to record status of the neighborhood.

Head to Toe Assessment – print same image front and back then cut to 4 1/4″ x 5 1/2″ – use one form for each victim

Victim Treatment Area – used to track victims in a treatment area

The following forms are used in the Incident Command Post. Leaders and Scribes should maintain a supply.

Incident Briefing

Personnel Resources

Assignment Status

Equipment Resources

Post-Incident Status