Staff Deployment Medical Evaluation Form

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Author: York City Bureau of Health

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Mini ME Staff Deployment Medical Evaluation Form id5337

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It is recognized that Public Health personnel are classified as First Responders. As such it is further recognized that they may be deployed into the field assisting in various roles during some emergency situations. Qualified, trained personnel are a valuable resource and measures will be taken to protect that resource. The Medical Evaluation-Short Form (MINI-ME) will be filled out and completed by Health Bureau command and the respective employee, reviewed and signed. MINI-ME provides a quick baseline of an employee prior to deployment into the field. The staff member will be interviewed upon returning from said deployment to determine any physical or psychological concerns that may impact their health or well-being. If necessary Health Bureau command will counsel the employee on available resources to assist then with any issues. This document does not replace or supercede any medical form or evaluation required by INCIDENT COMMAND at the emergency scene. All medical instructions and forms will be completed by deployed staff.

Program: Public Health Preparedness

Submitted Date: Nov 08, 2017 | Modified Date: Sep 30, 2025

Primary Toolkit: Project Public Health Ready (PPHR) Toolkit | Secondary Toolkit: N/A

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Institution Type: LHD - City, LHD - County,

Keywords: Project Public Health Ready (PPHR), Behavioral Health

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