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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.
County
Please list the county (or counties) your agency serves.
82681028104648819467438742263b79 Atlantic  
82681028104648819467438742263b79 Bergen 
82681028104648819467438742263b79 Burlington 
82681028104648819467438742263b79 Camden 
82681028104648819467438742263b79 Cape May 
82681028104648819467438742263b79 Cumberland 
82681028104648819467438742263b79 Essex 
82681028104648819467438742263b79 Gloucester 
82681028104648819467438742263b79 Hudson 
82681028104648819467438742263b79 Hunterdon 
82681028104648819467438742263b79 Mercer 
82681028104648819467438742263b79 Middlesex 
82681028104648819467438742263b79 Monmouth 
82681028104648819467438742263b79 Morris 
82681028104648819467438742263b79 Ocean 
82681028104648819467438742263b79 Passaic 
82681028104648819467438742263b79 Salem 
82681028104648819467438742263b79 Somerset 
82681028104648819467438742263b79 Sussex 
82681028104648819467438742263b79 Union 
82681028104648819467438742263b79 Warren 
Personnel
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?
88475449157f4ecfad51a756c4b55c32 Yes 
88475449157f4ecfad51a756c4b55c32 No 
If you have had COVID-19 personnel deaths, have you reported them to the NJDOH / ESF 8 desk?
88475449157f4ecfad51a756c4b55c32 Yes 
88475449157f4ecfad51a756c4b55c32 No 
Resources
What other resources does your department forecast may become critical?
82681028104648819467438742263b79 NONE 
82681028104648819467438742263b79 Personal Protective Equipment (PPE) 
82681028104648819467438742263b79 Medical Supplies 
82681028104648819467438742263b79 Support Personnel 
82681028104648819467438742263b79 Other (please list resource) 
Has your agency utilized, or are they currently utilizing, any of the following waivers?
82681028104648819467438742263b79 NONE 
82681028104648819467438742263b79 BLS Triage to Home 
82681028104648819467438742263b79 ALS Triage to Home 
82681028104648819467438742263b79 BLS Crewmember Requirements 
82681028104648819467438742263b79 MICU Crewmember Requirements 
82681028104648819467438742263b79 SCTU Crewmember Requirements 
82681028104648819467438742263b79 Unlicensed Vehicle 
82681028104648819467438742263b79 Out of State BLS Provider 
82681028104648819467438742263b79 BLS Certification Extension 
82681028104648819467438742263b79 Expired EMT Re-Entry - COVID19 
82681028104648819467438742263b79 Authorization for Paramedics to Work in Hospital Setting 
82681028104648819467438742263b79 ALS Certification Extension 
82681028104648819467438742263b79 Inactive to Active Paramedic 
82681028104648819467438742263b79 Expired Paramedic Re-Entry - COVID19 
82681028104648819467438742263b79 Executive order of One Paramedic Pronouncement