Please complete the following survey so that we can determine your availibility in the case of an actual HICS event. About You First Name Last Name Department Immediate Supervisor Contact InformationPlease provide us with the best number to reach you. Work Telephone Home Phone Cell Phone Memorial Sloan Kettering Email Address Memorial Sloan Kettering Email Address Confirm email Please Indicate Your Availability Wednesday Availability Not Available 11 PM to 7 AM Additional InformationPlease provide detailed answers when appropriate. If you have worked during an emergency previously, what did you do? What medical, nursing, or allied health training or experience do you have? Leave this field blank
