Ics Form 209 - Incident Status Summary Page 2
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23INCIDENT STATUS SUMMARY (ICS 209)
*1. Incident Name:
2. Incident Number:
Additional Incident Decision Support Information
A. # This
A. # This
Reporting
B. Total #
Reporting
B. Total #
*31. Public Status Summary:
*32. Responder Status Summary:
Period
to Date
Period
to Date
C. Indicate Number of Civilians (Public) Below:
C. Indicate Number of Responders Below:
D. Fatalities
D. Fatalities
E. With Injuries/Illness
E. With Injuries/Illness
F. Trapped/In Need of Rescue
F. Trapped/In Need of Rescue
G. Missing (note if estimated)
G. Missing
H. Evacuated (note if estimated)
H. Sheltering in Place
I. Sheltering in Place (note if estimated)
I. Have Received Immunizations
J. In Temporary Shelters (note if est.)
J. Require Immunizations
K. Have Received Mass Immunizations
K. In Quarantine
L. Require Immunizations (note if est.)
M. In Quarantine
N. Total # Civilians (Public) Affected:
N. Total # Responders Affected:
33. Life, Safety, and Health Status/Threat Remarks:
*34. Life, Safety, and Health Threat
Management:
A. Check if Active
A. No Likely Threat
B. Potential Future Threat
C. Mass Notifications in Progress
D. Mass Notifications Completed
E. No Evacuation(s) Imminent
F. Planning for Evacuation
G. Planning for Shelter-in-Place
H. Evacuation(s) in Progress
35. Weather Concerns (synopsis of current and predicted
weather; discuss related factors that may cause concern):
I. Shelter-in-Place in Progress
J. Repopulation in Progress
K. Mass Immunization in Progress
L. Mass Immunization Complete
M. Quarantine in Progress
N. Area Restriction in Effect
36. Projected Incident Activity, Potential, Movement, Escalation, or Spread and influencing factors during the next operational
period and in 12-, 24-, 48-, and 72-hour timeframes:
12 hours:
24 hours:
48 hours:
72 hours:
Anticipated after 72 hours:
37. Strategic Objectives (define planned end-state for incident):
ICS 209, Page 2 of ___
* Required when applicable.
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