Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home
HAN

 

 

 

This is an official
CDC HEALTH ADVISORY

Distributed via Health Alert Network
Thursday, September 08, 2005, 13:15  EDT (1:15  PM EDT)
CDCHAN-00234-2005-09-08-ADV-N

Medical Intake Form for Hurricane Katrina Evacuees

This interim form is intended to be used for medical intake assessment and triage of evacuees entering a shelter facility or evacuation center. The form can be used to identify evacuees who may need additional medical evaluation and treatment. The first page contains registration information for use by facility, local, and state authorities. The remaining pages can be used to anonymously report medical conditions among evacuees.

The form is available online at http://www.bt.cdc.gov/disasters/hurricanes/katrina/evacueeform.asp

The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations.

DEPARTMENT OF HEALTH AND HUMAN SERVICES


HAN Message Types
  • Health Alert: Conveys the highest level of importance; warrants immediate action or attention. Example: HAN00001
  • Health Advisory: Provides important information for a specific incident or situation; may not require immediate action. Example: HAN00316
  • Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action. Example: HAN00309
  • Info Service: Provides general information that is not necessarily considered to be of an emergent nature. Example: HAN00319

 

## This Message was distributed to State and Local Health Officers, Public Information Officers, Epidemiologists and HAN Coordinators as well as Clinician organizations ##

You have received this message based upon the information contained within our emergency notification database. If you have a different or additional e-mail or fax address that you would like us to use, please contact your State-based Health Alert Network program at your State or local health department.


Contact Us:
Ready.gov - Prepare. Plan. Stay Informed.
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC-INFO

A-Z Index

  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #