2024 Medical Response and Surge Exercise After-Action Report Survey

1. General Information

Please Note: Fields with an asterisk (*) require an answer.

*First and Last Name

*Title / Position

*Facility / Organization

*City / Town

*Email Address

*Confirm Email Address

Yes

Ambulatory Surgery Center

ARES

Clinic

Dialysis

EMS Agency

Home Health & Hospice

Hospital

Long Term Care

Office of Emergency Management

Mental Health / Public Health

Provider Agency (Private and Public)

Urgent Care