Developed by the New York Department of Health, this form will help Community Reception Center staff collect demographic and epidemiological information from highly contaminated individuals.
Radiation Tracking and Epidemiology Form
February 2012
Community Reception Center and Evacuation, Nuclear Detonation, Nuclear Power Plant Emergencies, Radiological Dispersal Devices / Radiological Exposure Devices (RDD / RED), State and Local Response Plans
Source: New York Department of Health