Survivor’s Needs – Do you have a need for any of the following? (please circle if yes)
Confidentiality: We respect your privacy. We will honor your wishes when sharing information about your needs. Please let us know of limitations. I understand that you may share this information for the purposes of reunification and reconciliation with my loved ones.
Signature _________________________________________________________ Date _____________________
This document is to be used to inform press briefings and media updates, but it is NOT a stand-alone document to be shared with the press. It should be completed using the judgment of the response staff, as not all items will be reported. All of the information below can be obtained from the Site Planning Section Lead at the Assistance Center or the Incident Planning Section Chief.