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. For radio transmissions, use the ICS 213R form near the bottom of the page.

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

The following link is to FEMA ICS forms. These are the current, standard ICS forms used nationwide. Many have been localized and are available elsewhere.

ICS forms

This is the current Lamorinda CERT ICS 213R form to be used with radios. Here are the instructions.