Questionnaire on CBRNE and Facility survey
CBRNE - Chemical Biological Radioactive Nuclear and Explosive
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1) Name of the Hospital / Institution *
2) Type of Hospital and Health Care Institution *
3) Name of Head of the Institution (Name of DDG/ PDHS/ RDHS/Director/Medical Superintendent)? *
4) Post – Permanent / Acting/ Cover up? *
5) Contact Mobile Number *
6) Contact Viber Number
7) Contact Whats App Number
8) Contact Email address (Please provide working and contactable Email) *
9) Whether Disaster Management Unit Available? *
10) Whether disaster focal point (Designated Medical Officer) present? *
11) If Medical Officer present, whether Post Graduate Diploma in Disaster Medicine done? *
12) Is there a documented Disaster Management Plan?  
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13) Are the Staff aware of it?
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14) If Disaster Management Plan present, whether disaster management drill is done?
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15) When was last drill performed?(Please mention the Date)  
16) Whether disaster management cupboard present?
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17) Are PPE present?
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18) Whether CBRNE knowledge sufficient of the staff members? *
19) Whether CBRNE training done? *
20) Do you need CBRNE Training immediately? *
21) Does your institute in line ministry or in provincial ministry? *
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