Family Emergency Plan

Make sure your family has a plan in case of an emergency. Before an emergency happens, sit down together and decide how you will get in contact with each other, where you will go and what you will do in an emergency. Keep a copy of this plan in your emergency essentials kit, or another safe place where you can access it in the event of a disaster.

Out-of-Town Contact Name: Telephone Number:
E-mail: Cell Phone Number:
   
Local Contact Name: Telephone Number:
E-mail Cell Phone Number:
   
Neighborhood Meeting Place: Telephone Number:
Out-of-Town Meeting Place: Telephone Number:


Fill out the following information for each family member and keep it up to date.

Name: Social Security Number: Date of Birth:
Important Medical Information:
 
Name: Social Security Number: Date of Birth:
Important Medical Information:
 
Name: Social Security Number: Date of Birth:
Important Medical Information:
 
Name: Social Security Number: Date of Birth:
Important Medical Information:
 
Name: Social Security Number: Date of Birth:
Important Medical Information:
 
Name: Social Security Number: Date of Birth:
Important Medical Information:
 


Write down where your family spends the most time: work, school and other places you frequent. Schools, daycare providers, workplaces and apartment buildings should all have site-specific emergency plans that you and your family need to know about.

Work Location One School Location One
Address: Address:
Phone Number: Phone Number:
Evacuation Location: Evacuation Location:
   
Work Location Two School Location Two
Address: Address:
Phone Number: Phone Number:
Evacuation Location: Evacuation Location:
   
Other place you frequent Other place you frequent
Address: Address:
Phone Number: Phone Number:
Evacuation Location: Evacuation Location:


Important Information Name Telephone Number Policy Number
Doctor(s):      
Other:      
Pharmacist:      
Medical Insurance:      
Homeowners/Rental Insurance:      
Veterinarian/Kennel (for pets):      

Dial 911 for Emergencies
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