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 supply kit or another safe place where you can access it in the event of a disaster.

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

Name:____________________________________  Social Security Number:_________________________                                         Important Medical Information:____________________________________________________________________
Date of Birth:________________________________

Name:_____________________________________Social Security Number:_________________________                                         Important Medical Information:____________________________________________________________________
Date of Birth:_________________________

Name:_____________________________________Social Security Number:_________________________                                         Important Medical Information:____________________________________________________________________
Date of Birth:_________________________

Name:_____________________________________Social Security Number:_________________________                                         Important Medical Information:____________________________________________________________________
Date of Birth:_________________________

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___________________________________________
Address:___________________________________________________
Phone Number:______________________________________________
Evacuation Location:__________________________________________

Work Location Two___________________________________________
Address:___________________________________________________
Phone Number:______________________________________________
Evacuation Location:__________________________________________

Work Location Three__________________________________________
Address:___________________________________________________
Phone Number:______________________________________________
Evacuation Location:__________________________________________

Other place you frequent_______________________________________
Address:___________________________________________________
Phone Number:______________________________________________
Evacuation Location:__________________________________________

School Location One__________________________________________
Address:__________________________________________________
Phone Number:_____________________________________________
Evacuation Location:__________________________________________

School Location Two__________________________________________
Address:___________________________________________________
Phone Number:______________________________________________
Evacuation Location:__________________________________________

School Location Three_________________________________________
Address:___________________________________________________
Phone Number:______________________________________________
Evacuation Location:__________________________________________

Other place you frequent_______________________________________
Address:__________________________________________________
Phone Number:_____________________________________________
Evacuation Location:__________________________________________

Important Information

Doctor(s):________________________Telephone Number _________________                                                                                                               Policy Number __________________
Other:___________________________Telephone Number_________________                                                                                                               Policy Number __________________
Pharmacist:_______________________Telephone Number_________________                                                                                                               Policy Number __________________
Medical Insurance:____________________Telephone Number _________________                                                                                                         Policy Number __________________
Home/Rent Insurance:________________Telephone Number   ________________                                                                                                                   Policy Number__________________
Veterinarian/Kennel (for pets):_______________Telephone Number____________                                                                                                         Policy Number __________________
 Dial 911 for Emergencies

 

Information from FEMA