COVID-19 Impact

Reporting Week
Please select the week you are reporting.
Agency Name
Please list your agency's official name (No abbreviations).
Contact Person
Please list the name and email address of the person completing this report.
Please list the county (or counties) your agency serves.
225a914f74c3434991895f08415fe353 Atlantic  
225a914f74c3434991895f08415fe353 Bergen 
225a914f74c3434991895f08415fe353 Burlington 
225a914f74c3434991895f08415fe353 Camden 
225a914f74c3434991895f08415fe353 Cape May 
225a914f74c3434991895f08415fe353 Cumberland 
225a914f74c3434991895f08415fe353 Essex 
225a914f74c3434991895f08415fe353 Gloucester 
225a914f74c3434991895f08415fe353 Hudson 
225a914f74c3434991895f08415fe353 Hunterdon 
225a914f74c3434991895f08415fe353 Mercer 
225a914f74c3434991895f08415fe353 Middlesex 
225a914f74c3434991895f08415fe353 Monmouth 
225a914f74c3434991895f08415fe353 Morris 
225a914f74c3434991895f08415fe353 Ocean 
225a914f74c3434991895f08415fe353 Passaic 
225a914f74c3434991895f08415fe353 Salem 
225a914f74c3434991895f08415fe353 Somerset 
225a914f74c3434991895f08415fe353 Sussex 
225a914f74c3434991895f08415fe353 Union 
225a914f74c3434991895f08415fe353 Warren 
What is your total number of personnel?
How many of your personnel are currently out sick due to testing positive for COVID-19?
How many of your personnel have been hospitalized due to COVID-19?
How many of your personnel are currently out due to self-quarantine for possible COVID-19 exposure?
How many of your personnel are currently out due to other reasons?
How many of your personnel were previously quarantined and have since returned to full duty?
Have any of your personnel succumbed to a COVID-19 related illness?
b75d1831e71a4c098e54ab4cdc3c72f8 Yes 
b75d1831e71a4c098e54ab4cdc3c72f8 No 
If you have had COVID-19 personnel deaths, have you reported them to the NJDOH / ESF 8 desk?
b75d1831e71a4c098e54ab4cdc3c72f8 Yes 
b75d1831e71a4c098e54ab4cdc3c72f8 No 
What other resources does your department forecast may become critical?
225a914f74c3434991895f08415fe353 NONE 
225a914f74c3434991895f08415fe353 Personal Protective Equipment (PPE) 
225a914f74c3434991895f08415fe353 Medical Supplies 
225a914f74c3434991895f08415fe353 Support Personnel 
225a914f74c3434991895f08415fe353 Other (please list resource) 
Has your agency utilized, or are they currently utilizing, any of the following waivers?
225a914f74c3434991895f08415fe353 NONE 
225a914f74c3434991895f08415fe353 BLS Triage to Home 
225a914f74c3434991895f08415fe353 ALS Triage to Home 
225a914f74c3434991895f08415fe353 BLS Crewmember Requirements 
225a914f74c3434991895f08415fe353 MICU Crewmember Requirements 
225a914f74c3434991895f08415fe353 SCTU Crewmember Requirements 
225a914f74c3434991895f08415fe353 Unlicensed Vehicle 
225a914f74c3434991895f08415fe353 Out of State BLS Provider 
225a914f74c3434991895f08415fe353 BLS Certification Extension 
225a914f74c3434991895f08415fe353 Expired EMT Re-Entry - COVID19 
225a914f74c3434991895f08415fe353 Authorization for Paramedics to Work in Hospital Setting 
225a914f74c3434991895f08415fe353 ALS Certification Extension 
225a914f74c3434991895f08415fe353 Inactive to Active Paramedic 
225a914f74c3434991895f08415fe353 Expired Paramedic Re-Entry - COVID19 
225a914f74c3434991895f08415fe353 Executive order of One Paramedic Pronouncement