MEDICAL PLAN (ICS-206)
Prepare Medical Plan (ICS-206). Click here for an electronic version of the form in Google Docs. Refer to the instructions below for guidance.
Medical Plan (ICS-206) provides important information on medical emergency procedures and the locations and telephone numbers of incident first-aid stations, transportation (ambulance) services, hospitals, urgent care facilities, clinics, etc.
Incident Name: Enter the name assigned to the incident.
Operational Period: Note the time interval for which the form applies. Record the start and end date and time (24-hour clock).
Medical First-aid Stations: Specify the names and addresses of incident medical first-aid stations. Include the telephone number (or designated radio channel/frequency) and indicate whether first-aid stations are staffed by paramedics/EMTs.
Ambulance Services: List the names and addresses of ground and air ambulance service providers. Include the telephone number (or designated radio channel/frequency) and indicate provided level of medical care, e.g., basic life support (BLS) or advanced life support (ALS).
Hospitals/Emergency Clinics: Identify nearby hospitals and urgent care facilities capable of supporting the incident. Enter the street address, telephone number, and estimated travel time, plus indicate whether the medical facility is provided with a burn center, trauma center, and/or helipad.
Summary of Medical Emergency Procedures: Include any special emergency instructions for use by incident personnel, e.g. incident reporting protocols, basic first-aid procedures, medical transportation arrangements, emergency decontamination guidelines, SDS contents, etc.
Prepared By: Record the name (and include the signature) of the individual completing the form.
ICS Position/Assignment: Document the ICS position (or assignment) of the individual completing the form.
Preparation Date/Time: Register the date and time the form was prepared.