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Healthcare Resource Assessment: Coroners
This survey is designed to collect information on those assets that your agency may access, activate, deploy, etc. during an emergency.
1. Agency Name:
2. Jurisdiction(s) covered - select all that apply
La Plata County
San Juan County
Southern Ute Indian Tribe
Ute Mountain Ute Indian Tribe
3. 24/7 primary agency contact - Name:
4. 24/7 primary agency contact - Phone:
5. 24/7 primary agency contact - E-mail:
6. 24/7 alternate agency contact - Name:
7. 24/7 alternate agency contact - Phone:
8. 24/7 alternate agency contact - E-mail:
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