Schuylkill County Office of Emergency Management

Schuylkill County EMA

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You are here: Home / Schuylkill County COAD Resource Survey

Schuylkill County COAD Resource Survey

Community Organizations Active in Disaster

Agency Address:(Required)
Service Area:(Required)

Organization Contacts

These are the staff that represent your organization on the COAD and/or would respond to a resource request during a disaster.
Primary Contact:(Required)
Secondary Contact:(Required)

Services your Organization can provide during a Disaster

Food & Water
Please check all that apply

Clothing
Please check all that apply

Shelter & Housing

Our location can be utilized for Mass Care.
Kitchen Available?
Are Pets Accepted?

Shelter Operations
Please check all that apply

Short Term & Housing Items
Please check all that apply

Transportation & Warehousing

Coordination of Services:
Available Vehicles
Please check all that apply
Support
Please check all that apply
Storage Facility
Please check all that apply

Medical

Coordination of Services
Medical Staffing
Please check all that apply
Medical Services
Please check all that apply

Social Services
Please check all that apply

Financial Assistance
Please check all that apply

Communications
Please check all that apply

Coordination of Unaffiliated Volunteers
Please check all that apply
Pet & Animal Services
Please check all that apply

Has your organization developed procedures to implement your disaster response services?(Required)
Name of Staff Member completing this survey(Required)
MM slash DD slash YYYY

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