Purpose: The HICS 205A - Communications List provides information on all radio frequencies, telephone, and other communication assignments for each operational period. ORIGINATION: Prepared by the Logistics Section Communications Unit Leader and given to the Planning Section Chief for inclusion in the Incident Action Plan (IAP). cOPIES TO: Duplicate and provide to all recipients as part of the IAP. All completed original forms must be given to the Documentation Unit Leader. Information from the HICS 205A can be placed on the Organization Assignment List (HICS 203). Notes: If additional pages are needed, use a blank HICS 205A and repaginate as needed. Additions may be made to the form to meet the organization’s needs. NUMBER TITLE INSTRUCTIONS 1 Incident Name Enter the name assigned to the incident. 2 Operational Period Enter the start date (m/d/y) and time (using the 24-hour clock) and end date and time for the operational period to which the form applies. 3 Internal Contacts Enter the appropriate contact information for internal contacts, hospital personnel, those in an activated Hospital Incident Management Team (HIMT) position, and other key staff. 4 Special Instructions Enter any special instructions (e.g., using repeaters, secure-voice, private line [PL] tones, etc.) or other emergency communications. If needed, also include any special instructions for alternate communication plans. 5 External Contacts Enter the appropriate contact information for external agencies, organizations, key contacts. Enter any special instructions (e.g., using repeaters, secure-voice, 6 Special Instructions private line [PL] tones, etc.) or other emergency communications. If needed, also include any special instructions for alternate communication plans. 7 Prepared by Enter the name and signature of the person preparing the form. Enter Communications Unit date (m/d/y), time prepared (24-hour clock), and facility. Leader
Purpose: The HICS 205A - Communications List provides information on all radio frequencies, telephone, and other communication assignments for each operational period. ORIGINATION: Prepared by the Logistics Section Communications Unit Leader and given to the Planning Section Chief for inclusion in the Incident Action Plan (IAP). cOPIES TO: Duplicate and provide to all recipients as part of the IAP. All completed original forms must be given to the Documentation Unit Leader. Information from the HICS 205A can be placed on the Organization Assignment List (HICS 203). Notes: If additional pages are needed, use a blank HICS 205A and repaginate as needed. Additions may be made to the form to meet the organization’s needs. NUMBER TITLE INSTRUCTIONS 1 Incident Name Enter the name assigned to the incident. 2 Operational Period Enter the start date (m/d/y) and time (using the 24-hour clock) and end date and time for the operational period to which the form applies. 3 Internal Contacts Enter the appropriate contact information for internal contacts, hospital personnel, those in an activated Hospital Incident Management Team (HIMT) position, and other key staff. 4 Special Instructions Enter any special instructions (e.g., using repeaters, secure-voice, private line [PL] tones, etc.) or other emergency communications. If needed, also include any special instructions for alternate communication plans. 5 External Contacts Enter the appropriate contact information for external agencies, organizations, key contacts. 6 Special Instructions Enter any special instructions (e.g., using repeaters, secure-voice, private line [PL] tones, etc.) or other emergency communications. If needed, also include any special instructions for alternate communication plans. 7 Prepared by Communications Unit Leader Enter the name and signature of the person preparing the form. Enter date (m/d/y), time prepared (24-hour clock), and facility.
HICS-205A-Communications-List.docx