Public Health EPP | Hospital EPP Attestation
Hospital Emergency Preparedness Plan (EPP) Attestation
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1.
Does your hospital have a written EPP that fits its community's characteristics?
(Required.)
Yes
No
*
2.
Does your hospital have a written EPP that prepares for future surges and emerging infectious diseases?
(Required.)
Yes
No
*
3.
Do you need EPP assistance?
(Required.)
Yes
No
Unsure
*
4.
Name of person completing this attestation (First and Last Name)
(Required.)
*
5.
Hospital Name
(Required.)
6.
CCN (if known)
*
7.
Email Address
(Required.)
