Emergency Information Form for Children With Special Health Care Needs

Home
Focus Areas
Disaster Preparedness
Pediatric Disaster Care Centers of Excellence (ASPR)
Region V for Kids
Children and Youth with Special Healthcare Needs
Patient, Family, and Provider Preparedness
Emergency Information Form for Children With Special Health Care Needs

Summary of Activities
Children and Youth with Special Healthcare Needs

Clinical Skills
Patient, Family, and Provider Preparedness
Be Ready Video

CONOPS: Leveling the Playing Field
Exercises
Family Reunification
Hazard Vulnerability Analysis & Metrics Score Card
Pediatric Disaster Education
Pediatric Facility Preparedness
Supply Chain
Telehealth
Workshops, Events & More

Audience

ED Clinicians
ED Clinicians
EMS Clinicians
Patients & Families

Media Type

App or Website

Duration

Guidance and resources (2010).

Emergency Information Form for Children With Special Health Care Needs

Guidance and resources.

What care setting do you primarily work in?

EMS or fire-rescue agency

Emergency department

Trauma center

Other clinical setting

I do not work in a clinical setting

Which EMS agency or hospital do you currently work for? (May select up to three)

If your agency or hospital is not listed above, please specify

Please make sure you have searched for your agency or department's full, official name above before adding it.

Form version*

Requested resource

User action*

Uuid*

EIIC Mission

To optimize outcomes for children across the emergency care continuum by leveraging quality improvement science and multidisciplinary, multisystem collaboration. Learn more about our impact

About EIIC
Contact Us
Internal Site (password required)
Sign Up

Facebook
Twitter
Youtube
Linkedin
Instagram

The EMSC Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $2.74M with 0 percent financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS or the U.S. government. For more information, visit HRSA.gov.