E2A2 Pre-Exercise Survey - New Item

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E2A2 Pre-Exercise Survey

- ASPR WorkGroup
  - ASPR WorkGroup
    - E2A2

Thank you for supporting the HHS and ASPR missions.

If you are attending an exercise soon led by a federal, state, or local organization, please help us record the exercise details by completing the Pre-Exercise Survey below.

This survey will time out in 60 minutes.

Exercise Details

Use the dropdown field below to select your exercise. If your exercise is not listed, please continue to Exercise Name

Note: By selecting an exercise from the drop-down, data fields will pre-populate with information submitted by other participants from that exercise. Please be sure to confirm the pre-populated information is accurate. If it is not, please edit those fields accordingly in your entry.

Exercise Name *

Participant First Name *

Participant Last Name *

Email Address
*

Start Date *

End Date *

Exercise Location (State / Territory) *

Location (City) *

Exercise Type *

Discussion Sub-Type

Operations Sub-Type

Exercise Scenario *

Scenario Natural

Scenario Technological

Scenario Human Caused

Scenario NSSE

Scenario Other

Part of Series *

Yes

No

Lead Organization(s) *

HHS	State
DHS	Local
DoD	Tribal
VA	Other
Private

Please specify HHS (e.g., ASPR, CDC, etc.)

Please specify DHS (e.g., FEMA)

Please specify DOD (e.g., Army)

Please specify VA (e.g., VHA)

Please specify State / Territory

Lead Organization(s) Other

Participant Role in the Exercise *

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