Under the National Defense Authorization Act, the Secretary of Defense was tasked with the development and implementation of a program for testing and improving the responses of Federal, State, and local agencies to emergencies involving weapons of mass destruction. The first phase of this program, known as the Domestic Preparedness Program, concentrated on highly populated metropolitan areas. In 1997, the City of Dallas received the Domestic Preparedness Program’s community-wide analysis. The analysis examined the resources, strengths, and weaknesses in the existing municipal services and medical community. In 2001, the development of the Dallas Metropolitan Medical Response System, involving several government and community agencies, was completed. The Parkland Health and Hospital System actively participated in the development and implementation of medical community education and hospital facility preparations specific to potential acts of terrorism. This report outlined the steps taken by Parkland Health and Hospital System, as well as other participating agencies, in the development of a medical response plan that included: (1) defining the problem; (2) defining critical functions to event mitigation, such as safety and security, decontamination, acute and definitive medical care, communications, and resource procurement and management; and (3) developing procedures for weapons of mass effect and department specific responses.