Santa Barbara County
Disaster Healthcare Partners Coalition
Commitment to Participate
Signature Page
To assure collaborative planning and efficient response during a disaster, the Disaster
Healthcare Partners, a coalition with a defined structure, including formal membership of
partners and the establishment of an Emergency Preparedness Advisory Committee and
Executive Committee, was implemented in Santa Barbara County in 2013.
__________________________________ (organization’s name)
will participate as an official member of the Santa Barbara County Disaster Healthcare
Partnership Coalition.
By signing below I acknowledge that I have read the Disaster Health Partners Coalition
Governance Document and that our organization agrees to participate in the coalition
according to the bylaws and responsibilities established in the Santa Barbara County Disaster
Healthcare Partners Coalition Document.
Organization’s Executive Signature
/
Organization’s Disaster Coordinator Signature
Name and Title printed /
Date
/Name and Title Printed /
Date