INCIDENT ACTION PLAN (IAP) QUICK START
COMBINES NHICS FORMS 201+202+203+204+215A
PURPOSE: COMBINES NHICS FORMS 201+202+203+204+215A
ORIGINATION: INCIDENT COMMANDER OR PLANNING SECTION CHIEF
COPIES TO: ALL IMT STAFF
NHICS 200
PAGE __ of __
REV. 2017
1. INCIDENT NAME
2. OPERATIONAL PERIOD
DATE: FROM: TO:
TIME: FROM: TO:
3. SITUATION SUMMARY
4. WEATHER/ENVIRONMENTAL IMPLICATIONS FOR PERIOD
(INCLUDES AS APPROPRIATE: FORECAST, DAYLIGHT)
1.
2.
3.
4.
-- NHICS 201 --
INCIDENT ACTION PLAN (IAP) QUICK START
COMBINES NHICS FORMS 201+202+203+204+215A
PURPOSE: COMBINES NHICS FORMS 201+202+203+204+215A
ORIGINATION: INCIDENT COMMANDER OR PLANNING SECTION CHIEF
COPIES TO: ALL IMT STAFF
NHICS 200
PA
GE __ of __
REV. 2017
5.
CURRENT ORGANIZATION
INCIDENT COMMANDER
LIAISON/PUBLIC
INFORMATION OFFICER
SAFETY OFFICER
MEDICAL
DIRECTOR/SPECIALIST
OPERATIONS SECTION
CHIEF
PLANNING SECTION
CHIEF
LOGISTICS SECTION
CHIEF
FINANCE/
ADMINISTRATION
SECTION CHIEF
RESIDENT SERVICES
BRANCH DIRECTOR
INFRASTRUCTURE
BRANCH DIRECTOR
(Fill in additional positions as appropriate)
INCIDENT ACTION PLAN (IAP) QUICK START
COMBINES NHICS FORMS 201+202+203+204+215A
PURPOSE: COMBINES NHICS FORMS 201+202+203+204+215A
ORIGINATION: INCIDENT COMMANDER OR PLANNING SECTION CHIEF
COPIES TO: ALL IMT STAFF
NHICS 200
PA
GE __ of __
REV. 2017
6. INCIDENT OBJECTIVES
6a. OBJECTIVES 6b. STRATEGIES/ TACTICS 6c. RESOURCES REQUIRED 6d. ASSIGNED TO
7. HEALTH AND SAFETY BRIEFING IDENTIFY POTENTIAL INCIDENT HEALTH AND SAFETY HAZARDS AND DEVELOP
NECESSARY MEASURES (REMOVE HAZARD, PROVIDE PERSONAL PROTECTIVE EQUIPMENT, WARN PEOPLE OF THE HAZARD)
TO PROTECT RESPONDERS FROM THOSE HAZARDS
1.
2.
3.
4.
8. ATTACHMENTS (MARK IF EXTRA DOCUMENTATION IS ATTACHED)
NHICS 251: FACILITY SYSTEM STATUS REPORT
NHICS 254: EMERGENCY ADMIT TRACKING
NHICS 255: MASTER RESIDENT EVACUATION TRACKING
NHICS 215A: INCIDENT ACTION PLAN (IAP) SAFETY ANALYSIS
TRAFFIC PLAN
INCIDENT MAP
OTHER:
9. PREPARED BY
PRINT NAME:
SIGNATURE:
DATE/TIME:
FACILITY:
-- NHICS 202, 204--
-- NHICS 202, 215A--
CLEAR FORM
INCIDENT ACTION PLAN (IAP) QUICK START
COMBINES NHICS FORMS 201+202+203+204+215A
PURPOSE: COMBINES NHICS FORMS 201+202+203+204+215A
ORIGINATION: INCIDENT COMMANDER OR PLANNING SECTION CHIEF
COPIES TO: ALL IMT STAFF
NHICS 200
PA
GE __ of __
REV. 2017
INSTRUCTIONS
PURPOSE:
Provides a faster approach to developing the IAP by combining NHICS Forms 201, 202, 203,
204 and 215A. You may use the IAP Quick Start during the early stage of an incident or if it is
expected to be a short duration incident or it meets the needs of the incident at any time. If
the full complement of NHICS Forms are needed, transition to their individual use.
ORIGINATION:
Incident Commander or Planning Section Chief
COPIES TO:
All IMT staff
NOTES:
If additional pages are needed for any form page, use a blank NHICS IAP Quick Start and
repaginate as needed. Additions may be made to the form to meet the organization’s needs.
* Three versions of the IMT Chart are available in NHICS 2016. Formats are Adobe Acrobat
fillable PDF, Visio and Microsoft Word.
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 (24-hour clock) and end date
and time for the operational period to which the form applies.
3
Situation Summary
Enter brief situation summary.
4
Weather/Environmental
Implications for period
Enter forecast information.
5
Current Organization
Enter the names of the individuals assigned to each position on the
Incident Management Team chart. Modify the chart as necessary.
6
Incident Objectives
6.a Objectives
Enter each objective separately. Adjust objectives for each operational
period as needed.
6.b Strategies/Tactics
For each objective, document the strategy/tactic to accomplish that
objective.
6.c Resources Required
For each strategy/tactic, document the resources required to
accomplish that objective.
6.d Assigned to
For each strategy/tactic, document the Section or Branch assigned to
that objective.
7
Health and Safety
Briefing
Summary of health and safety issues and instructions.
8
Attachments
Attach additional NHICS forms and supporting documents as needed.
9
Prepared By
Enter the name and signature of the person preparing the form. Enter
date (m/d/y), time prepared (24-hour clock), and facility.
