Forms and Documents

CDC Documents

Doxycycline for Post-Exposure Prophylaxis of Anthrax  (PDF - 192.0 KB)

Ciprofloxacin for Post-Exposure Prophylaxis of Anthrax  (PDF - 183.9 KB)

How to Take Ciprofloxacin to Prevent Anthrax (PDF - 177.3 KB)

IDPH Documents

Amoxicillin Dosing Brochure (PDF - 350.7 KB)

Ciprofloxacin Dosing Brochure (PDF - 453.8 KB)

Doxycycline Dosing Brochure (PDF - 535.3 KB)

Tamiflu Dosing Brochure (PDF - 356.1 KB)

HICS Forms

HICS-Incident Action Plan (IAP) Quick Start (DOCX - 76.9 KB)

HICS-201 Incident Briefing (DOCX - 125.7 KB)

HICS-201 Incident Briefing (PDF - 417.6 KB)

HICS-202-Incident-Objectives (PDF - 414.2 KB)

HICS-203-Organization-Assignment (PDF - 412.5 KB)

HICS-204-Branch-Assignment-List (PDF - 411.8 KB)

HICS-205-Incident-Communication-Log (PDF - 442.1 KB)

HICS-206-Staff-Medical-Plan (PDF - 411.4 KB)

HICS-207-Organizational-Chart (PDF - 418.2 KB)

HICS-213-Incident-Message-Form (PDF - 413.7 KB)

HICS-214-Operational-Log (PDF - 410.5 KB)

HICS-251-Facility-System-Status-Report (PDF - 441.7 KB)

HICS-252-Section-Personnel-Time-Sheets (PDF - 411.0 KB)

HICS-253-Volunteer-Staff-Registration (PDF - 410.7 KB)

HICS-254-Disaster-Victim-Patient-Tracking-Form (PDF - 411.1 KB)

HICS-255-Master-Patient-Evacuation-Tracking-Form (PDF - 407.2 KB)

HICS-256-Procurement-Summary-Report (PDF - 407.0 KB)

HICS-257-Resource-Accounting-Record (PDF - 24.8 KB)

HICS-258-Hospital-Resource-Directory (PDF - 446.6 KB)

HICS 259 Hospital Casualty-Fatality Report (PDF - 24.9 KB)

HICS-260-Patient-Evacuation-Tracking-Form (PDF - 412.0 KB)

HICS-261-Incident-Action-Plan-Safety-Analysis (PDF - 410.3 KB)

Job Action Sheets

Incident Commander - JAS (PDF - 300.8 KB)

Public Information Officer - JAS (PDF - 73.0 KB)

Safety Officer - JAS (PDF - 71.8 KB)

Liason Officer - JAS  (PDF - 69.4 KB)

Finance & Administration Section Chief - JAS (PDF - 76.1 KB)

Logistics Section Chief - JAS (PDF - 75.6 KB)

Operations Section Chief - JAS (PDF - 80.1 KB)

Planning Section Chief - JAS  (PDF - 76.6 KB)

1135 Waiver

Requesting an 1135 Waiver (PDF - 65.1 KB)

EMTALA Waiver Toolkit (PDF - 71.5 KB)

ASPR-HIPPA Emergency Fact Sheet

ASPR-HIPPA Emergency Fact Sheet (PDF - 161.5 KB)

Planning for At-Risk and Functional Access Needs

Requesting an 1135 Waiver (PDF - 65.1 KB)

Illinois Helps

CHEMPACK Overview Peoria Region 2018 (PDF - 821.3 KB)

SNS & CHEMPACK

Strategic National Stockpile Overview 2018  (PDF - 574.6 KB)

CHEMPACK Overview Peoria Region 2018 (PDF - 821.3 KB)

Illinois-Iowa CHEMPACK Overview 2019 (PDF - 1.3 MB)