2. First Name*
3. Last Name*
5. *True or False: The Director of the County Health Department is authorized to involuntarily isolate and quarantine citizens to prevent the spread of disease*
   -- Select One --TrueFalse
7. Which of the following are strategies to meet public health emergencies?*
   -- Select One --Isolate, diagnose and treat casesEstablish surveillance and conduct epidemiologic investigationsEstablish and operate mass dispensing/vaccination sitesAll of the above
9. Which of the following is NOT a requirement to be in Loudoun's MRC?*
   -- Select One --Be available to serve in an emergencyBe a healthcare providerLive or work in Loudoun CountyAll are required
11. MRC volunteers are NOT required to complete which of the following trainings?*
    -- Select One --CPROrientationIS700IS100
13. True or False: Depending on the need, medically trained MRC members may be used in non-medical roles*
    -- Select One --TrueFalse
15. What is the primary role of Loudoun's MRC?*
    -- Select One --Staffing sheltersStaffing mass dispensing/vaccination sitesProviding community education on important public health issuesTreating sick patients
17. The Code of Virginia addresses legal liability issues under which of the following section(s)?*
    -- Select One --Section 44Good Samaritan LawBothNeither
19. True or False: The majority of people who staff a mass vaccination clinic would need to have medical training*
    -- Select One --TrueFalse
21. Our worst case scenario currently is based on ____ days of operations using ___ mass distribution sites*
    -- Select One --2, 54, 61, 88, 8
23. True or False: You may talk with your family about health information that you receive while engaged in MRC activities.*
    -- Select One --TrueFalse
25. True or False: Under ICS, you may report to several supervisors*
    -- Select One --TrueFalse
27. Under ICS, the span of control is:*
    -- Select One --1-53-74-95-10
29. True or False: Under ICS, the highest ranked person fills a position, regardless of qualification*
    -- Select One --TrueFalse
31. ICS is based on:*
    -- Select One --Academic researchBest practicesStrengthsStructures
33. This is the basis for all preparedness:*
    -- Select One --The federal governmentNIMSFamily and personal preparednessThe state government
35. True or False: PHI cannot be disclosed to any other people or medical entities without the written consent of the patient*
    -- Select One --TrueFalse
37. True or False: You should check/update your VVHS account regularly and notify the MRC coordinator if any of your information changes*
    -- Select One --TrueFalse
39. True or False: You should respond as directed to all periodic VVHS alerts*
    -- Select One --TrueFalse
41. True or False: The Health Department also relies on the MRC for non-emergency support*
    -- Select One --TrueFalse
43. What is your email address?*
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field