Healthcare Surge: Facility On-Site Damage/Operability Form

Form Template

The Healthcare Surge: Facility On-Site Damage/Operability Form mobile app is a comprehensive assessment and will aid in the decision for keeping the facility open or evacuating staff.

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During a catastrophic emergency, the facility should be checked to ensure the following: Structural integrity, Availability of communications and elevators (if applicable), Availability of water: from utility, drinking and hot, Functionality of building systems such as electricity, emergency power, fuel reserve, heating and cooling, and sewage disposal, Availability of supplies including food, medications, linens and other items and Availability of resources such as administration, nursing, dietary and housekeeping. GoCanvas allows you to capture signatures, insert photos, capture GPS coordinates, dispatch technicians to jobs, conduct calculations and utilize common form fields like drop-downs, checkboxes, text boxes, and more.

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