Disclaimer of Information & Content: AzCHER has no authority to bind a staffing agency and a facility and has no other authority, power, or use is granted or implied. The resources provided are for information only, not advice or guarantee of outcome. Information is gathered and shared from reputable sources, however, AzCHER is not responsible for error or omissions. AzCHER does not endorse or promote any single agency over another, nor do we suggest that there are no other viable agencies. AzCHER gives no assurance or warranty regarding accuracy, timeliness, or applicability of the content. The information provided and shared is as a resource only. AzCHER may not incur any debt, obligation, expense, or liability of any kind. Each party agrees to comply with all applicable local, state, and federal laws or regulations.
If you have specific staffing needs, please fill out a 213RR Request Form or the form linked to your local county public health department provided here. This form must be sent to your local public health department for processing and a courtesy copy should be sent to [email protected]. Within the body of the e-mail, include the name of your facility and the city where you are located. If a request has been fulfilled, we ask that you contact the AzCHER team so you can be removed from the request log.
AzCHER may be able to assist your organization if it is encountering issues with securing key staff due to the COVID-19 pandemic. Please follow the steps below.
- Exhaust all other avenues of securing the needed resources (e.g. working within the healthcare system or your organization’s sister facilities; contacting all contracted vendors).
- Complete ICS Form 213 RR.
- First, submit the completed form to your local public health department through the contact methods provided here.
- Then, submit a copy of the completed form to [email protected].
Instructions for Completing ICS 213 RR
Complete ONLY the following sections:
- #1 – Incident Name = COVID-19
- #2 – Date and Time you are completing the form
- #4 – Your Order:
- Quantity = the number of each type of staff needed
- Type of Staff = Physicians, ICU Nurses, Med/Surge Nurses, Respiratory Therapists, LPNs, CNAs, Med Techs/Caregivers
- Detailed Description, such as length of time staff is needed
- Do not complete the Arrival Time and Cost sections
- #5 – Requested Date / Reporting Location = where staff should be sent
- #7 – Requested by Name and Position = person requesting and their contact information
- #8 – Priority = Urgent, Routine, or Low
Apache County Public Health
Request form 213rr to be completed and sent to [email protected]
Cochise County Public Health
Requests to be submitted at https://crh.arizona.edu/ppe/cochise
Coconino County Public Health
Request form 213rr to be completed and sent to [email protected]
Gila Public Health Department
Request form 213rr to be completed and sent to [email protected] or [email protected]
Graham County Public Health
Request form 213rr to be completed and sent to [email protected]
Greenlee County Public Health
Request form 213rr to be completed and sent to [email protected]
La Paz County Public Health and Emergency Management
Request form 213rr to be completed and sent to [email protected] and [email protected]
Maricopa Public Health Department
Resource requests to be submitted at https://www.maricopa.gov/5585/Request-Resources
Mohave County Public Health
Request form 213rr to be completed and sent to [email protected]
Navajo County Public Health
Request form 213rr to be completed and sent to [email protected]
Pima County Public Health
Requests to be submitted at https://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=533608
Pinal Public Health Department
Request form 213rr to be completed and sent to [email protected]
Santa Cruz County Public Health
Request form 213rr to be completed and sent to [email protected]
Yavapai County Public Health
Request form 213rr to be completed and sent to [email protected]
Yuma County Public Health
Requests to be submitted at https://forms.gle/HkRtUM3yBdB2bihcA