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NHICS FORM 255 MASTER RESIDENT EVACUATION TRACKING FORM 1. INCIDENT NAME 2. FACILITY NAME 3. DATE PREPARED 4. RESIDENT TRACKING MANAGER 5. RESIDENT EVACUATION INFORMATION RESIDENT NAME DISPOSITION MODE OF TRANSPORTATION HOME FACILITY TRANSFER TEMP. SHELTER TIME FACILITY CONTACTED REPORT GIVEN ACCEPTING FACILITY NAME CONTACT INFO YES NO MEDICATION SENT MD/FAMILY NOTIFIED ARRIVAL CONFIRMED TIME/TRANSPORT CO. MED RECORD SENT TRANSFER INITIATED MEDICAL RECORD 6. CERTIFYING OFFICER 7. DATE/TIME SUBMITTED PURPOSE RECORD INFORMATION CONCERNING RESIDENT DISPOSITION DURING A FACILITY EVACUATION ORIGINATION OPERATIONS BRANCH COPIES TO PLANNING SECTION CHIEF AND DOCUMENTATION UNIT LEADER LEADER NHICS 255 PAGE 1 of REV. RESIDENT TRACKING MANAGER 5. RESIDENT EVACUATION INFORMATION RESIDENT NAME DISPOSITION MODE OF TRANSPORTATION HOME FACILITY TRANSFER TEMP. SHELTER TIME FACILITY CONTACTED REPORT GIVEN ACCEPTING FACILITY NAME CONTACT INFO YES NO MEDICATION SENT MD/FAMILY NOTIFIED ARRIVAL CONFIRMED T....

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How to fill out the Nhics 255 online

The Nhics 255 form is essential for accurately tracking resident evacuation information during an emergency. This guide provides clear instructions for completing the form to ensure all necessary details are recorded accurately.

Follow the steps to complete the Nhics 255 form online.

  1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
  2. In the first section, enter the incident name in the designated field. This identifies the specific event associated with the evacuation.
  3. Next, provide the facility name where the residents are located, ensuring accuracy for better tracking.
  4. Fill in the date prepared to indicate when the form was completed. This is crucial for record-keeping.
  5. Identify the resident tracking manager responsible for overseeing the evacuation. Include their contact information for accountability.
  6. For each resident, fill in their name and specify their disposition, indicating where they have been transported (home, facility transfer, or temporary shelter).
  7. Record the mode of transportation used for each resident in the relevant section.
  8. Document the time the facility was contacted and report information given regarding the evacuation.
  9. Provide the name and contact information for the accepting facility where each resident is being transferred.
  10. Indicate whether the resident's medical records were sent, and whether their medication was also transferred.
  11. Confirm if the family or medical doctor was notified about the resident's transportation and if their arrival has been confirmed, including timestamps.
  12. Repeat the above steps for additional residents as needed, ensuring each entry is complete and accurate.
  13. Complete the certification section by entering the certifying officer's name and the date and time the form is submitted.
  14. After all sections are filled, save changes, download, print, or share the form as required.

Start filling out the Nhics 255 form online to ensure proper resident tracking during an evacuation.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232