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					Ver. 6
OEM Number Report prepared by County

OREGON EMERGENCY MANAGEMENT
SEARCH AND RESCUE INCIDENT SUMMARY County Case Number

Ver. 6

Date of Incident Phone

WAS ASSISTANCE PROVIDED  By another Agency, County, or State to you? Which one(s)?  By you to another Agency, County, or State? Which one(s)?

SAR INCIDENT TYPE - What type of incident did this involve?
 This mission involved more than one type of incident  Aviation  Beacon searches  Missing person (land)  Evidence search (land)  Missing person (water)   Evidence search (water)   Training  Public event      Emergency Management (disasters)  False - callout reason  Rescue (land)  Body recovery from  Rescue (water)     land  water  Other water incident  Other (specify)

SUBJECT ACTIVITY - What was the subject doing?
 Helicopter  ATV  Caving  Government work  Mushroom picker  Fishing  Cross country skiing  Powered watercraft  SCUBA / snorkeling  Suicide  Any other activities  Fixed wing  Other aviation  Motor vehicle - Intentions  Climbing  Hiking / camping  Other work  Bicycling  Other picker  Other forest activity  Hunting (game)  Hunting (bird)  Snowboarding  Snowmobile  Non-powered watercraft: What type?  Swimming  Other water activity  Wandering  Criminal  Military aircraft?  Horseback riding  Other snow sports  Unknown

LAND USE - On whose land did the incident initiate?
 Private  County  Dept. of Interior  USFS  State  BLM  ODF  Parks & Rec.  Other (specify)  Native

SIGNALING - What did the subject use?
 ELT  Fire/smoke  EPIRB  Flare/pyro  PLB  MLU  Cell Phone  Radio  Sound (gun, whistle)  Visual (markers, flags)  Mirror

SUBJECT DATA AND MISSION RESULTS
Age(s): Males  Oregon resident? Home county: Results: Recovered: Alive Found by: Self-recovered: Family / friends: Distance traveled on foot from PLS: MENTAL STATE - Describe the mental status of the subject (if applicable) For multiple subjects with different status, identify by age and sex: subject 1 Alzheimer’s Mental illness Autism Dementia type Mental handicaps Other Alcohol Methamphetamine Cocaine Hallucinogen Other
1 1 1 1 2 2 2 2 3 3 3 3 1 1 1 1 2 2 2 2 3 3 3 3 1 1 1 2 2 2 3 3 3

Females or Home state: Deceased Ground SAR: SAR dogs: Remains missing Air SAR: Other:

subject 2
1 2 3

subject 3

Mood disorder Opiate
1 2 3

1

2

3

Marijuana

Date and time: Overdue:

Reported:

Found:

Mail to: Oregon Emergency Management, P.O. Box 14370, Salem, OR 97309-5062

SAR ASSETS USED TRANSPORTATION (Circle h (hours) or m (miles))
[ [ [ [ [ ]h ]h ]h ]h ]h m m m m m Helicopter Helicopter(military) Snowmobile 4-wheel drive Other [ [ [ [ ]h ]h ]h ]h m m m m Fixed wing Fixed wing (military) Snow-Cat Specialized vehicles [ [ [ [ ]h ]h ]h ]h m m m m ATVs Motorcycle Watercraft 2-wheel drive

PERSONNEL - PAID (hours)
[ [ [ [ [ [ ] CAP ] Forest Service ] Mt. Rescue ] Ski patrol ] Law enforcement ] Other ground SAR (who?) [ [ [ [ [ ] Divers ] Federal agency (other) ] Dog team (dog & handler) ] Horse team (horse & rider) ] Sheriff’s SAR team [ [ [ [ [ ] BLM ] Explorers ] Jeep club ] Fire service ] State agency

PERSONNEL - VOLUNTEER (hours)
[ [ [ [ [ [ ] CAP ] Forest Service ] Mt. Rescue ] Ski patrol ] Law enforcement ] Other ground SAR (who?) [ [ [ [ [ ] Divers ] Federal agency (other) ] Dog team (dog & handler) ] Horse team (horse & rider) ] Sheriff’s SAR team [ [ [ [ [ [ ] BLM ] Explorers ] Jeep club ] Fire service ] State agency ] Amateur radio

DIRECT COSTS - Non-budgeted expenses paid during the mission.
[ [ ] Food ] Other expenses (describe) [ ] Fuel [ ] Lodging

NARRATIVE

(briefly describe incident)

___

Mail to: Oregon Emergency Management, P.O. Box 14370, Salem, OR 97309-5062


				
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