After Action Review Input Form

This form should only be completed by incident response personnel who were on scene at the time of the incident.

Name

First Last

Agency

Date of form

Phone or Email

Date of Incident

Incident Type

Incident cause and recommendations for future correction or prevention

Location

Incident Notification Time

Time of Arrival

Roadway Clearance Time

All lanes open for travel

Incident Clearance Time

All responders left the scene

Time of Departure

Who notified you of the incident, when and how?

Describe the situation upon your arrival to the scene:

Describe the Plan of Action that was established.

Was Unified Incident Command established?

Yes

Was the media notified of the incident?

Yes

Number of responders on scene

Other Agency on Scene

Additional Notes

Were you made aware of detours or other traffic changes?

Yes

What detours or traffic changes were made to alleviate congestion or the flow of traffic?

What resources or services did you provide?

What assignments or orders were given?

Briefly explain any problems you encountered and how they were resolved.

Briefly explain what went well during the response.

Briefly explain areas for improvement.

Based on the event are there policies and procedures that need to be updated or developed?

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