CP Form 1: Hazard Analysis
HAZARD
PROBABILITY
RATE
REMARKS
IMPACT
RATE
REMARKS
AVERAGE
PROBABILITY + IMPACT
2
RANK
CP Form 2: Anatomy of the Hazard
HAZARD TO PLAN FOR
ROOT CAUSES
EARLY WARNING SIGNS
TRIGGERING FACTORS
EXISTING
MITIGATING MEASURES
CP Form 3A: Scenario Generation for Natural Hazard
PARTICULARS
(CAN BE CUSTOMIZED)
General Description of Event
No. of Affected Individuals
No. of Dead
No. of Injured
No. of Missing
EFFECTS
Communication
Power/ Electricity
Transportation
Environment
Response Capabilities
Government Trust
Others_________
Others_________
Others_________
BAD
WORSE
WORST
CP Form 3B: Scenario Generation for Human-Induced Hazard
PARTICULARS
MOST LIKELY
BEST
(CAN BE CUSTOMIZED)
(NORMAL ACTIVITIES)
(WITH COUNTER-MEASURES)
General Description of Event
No. of Affected Individuals
No. of Dead
No. of Injured
No. of Missing
EFFECTS
Communication
Power/ Electricity
Transportation
Environment
Response Capabilities
Government Trust
Others_________
Others_________
Others_________
WORST
CP Form 4A: Affected Population
DISPLACED POPULATION
AREA/ LOCATION
TOTAL
NO. OF INDIVIDUALS
AFFECTED
(FOR LOCAL GOVERNMENT UNITS ONLY)
NO. OF INDIVIDUALS INSIDE NO. OF INDIVIDUALS OUTSIDE
EVACUATION CENTERS
EVACUATION CENTERS
REASONS FOR
DISPLACEMENT
CP Form 4B: Breakdown of Affected Population
AREA/
LOCATION
NO. OF
INDIVIDUALS
AFFECTED
M
TOTAL
F
BREAKDOWN
(FILL-UP ONLY WHEN APPROPRIATE)
INFANT
(0-11 MONTHS)
M
F
CHILDREN
(17 YO &
BELOW)
ADULT
(18-59 YO)
ELDERLY
(60 YO &
ABOVE)
M
M
M
F
F
F
PERSONS WITH
DISABILITY
(PWD)
M
F
WITH
SICKNESS
M
F
PREGNANT
WOMAN
OTHERS
CP Form 5: Cluster Identification
AGENCIES/OFFICES INVOLVED
(NUMBER OF FIELDS CAN BE INCREASED OR REDUCED)
RESPONSE CLUSTER
LEAD AGENCY/OFFICE
Summary of CP Form 5
RESPONSE CLUSTER
LEAD AGENCY/ OFFICE
MEMBER AGENCIES/OFFICES
CP Form 7: Resource Inventory
RESPONSE CLUSTER
AGENCY/OFFICE
RESOURCE
QUANTITY
REMARKS
CP Form 8: Resource Projection
RESPONSE
CLUSTER
RESOURCE
TOTAL
NEED
HAVE
GAPS
(NEED – HAVE)
ACTIVITIES/ SOURCES
TO FILL THE GAPS
COST ESTIMATES
SOURCE OF FUNDS
(FILL-UP ONLY WHEN
APPROPRIATE)
(FILL-UP ONLY WHEN
APPROPRIATE)
CP Form 9: Resource Gap Summary
RESPONSE CLUSTER
TOTAL
TOTAL RESOURCE GAPS
TOTAL COST ESTIMATES
CP Form 10: Emergency Operations Center
LOCATION
CONTACT INFORMATION
Primary
Landline:
Alternate
Satellite Phone:
Mobile:
Radio Frequency:
Email Address:
Others:
Social Media:
Others:
POSITION
(CUSTOMIZE AS APPROPRIATE)
EOC MANAGEMENT TEAM
NAMES AND AGENCY/
OFFICE/
ORGANIZATION
(PRIMARY AND ALTERNATE)
EOC Manager
Operations Coordinator
Planning Coordinator
Logistics Coordinator
Finance/ Admin
Coordinator
Others___________
Others___________
Others___________
CONTACT
INFORMATION
(PRIMARY AND ALTERNATE)
CP Form 11: Incident Command System
FACILITIES
ICS FACILITIES
LOCATIONS
(CUSTOMIZE AS APPROPRIATE)
Incident Command Post
Staging Area
Base
Camp
Helispot
Helibase
Others___________
Others___________
Others___________
INCIDENT MANAGEMENT TEAM
POSITION
NAMES AND AGENCY/
CONTACT
(CUSTOMIZE AS APPROPRIATE)
OFFICE/
INFORMATION
(PRIMARY AND ALTERNATE)
ORGANIZATION
(PRIMARY AND ALTERNATE)
Incident Commander
Public Information
Officer
Liaison Officer
Safety Officer
Operations Section
Chief
Planning Section Chief
Logistics Section Chief
Finance/Admin Section
Chief