Family Emergency Plan Template
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2Ready.Responder
Family Emerge cy Plan
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Make sure you rfam ily 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 kitor another safe place where you can access it in the event of a disaster.
Out-of-Town Contact Name:
Emaill:
Neighborhood Meeting Pl.ace:
lRegional Meeting Place:
Evacuation Location:
Tele Ilone Number:
Telepllone Number:
Tele Ilone Number:
Telepllone Number:
Fill out the following information for each family member and keep it up to date.
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
Sociall
Secu~i~
Number:
Imll0rta nt Medica I Information:
Socia liSe cu!ity Numbe r:
Importa nt Medica I Illformalioll:
SociallSecul'i
Number:
1m ortant Medical Information:
Sociall
Secul'i~mber:
1m ortant Medical Information:
Socia liSe curi!>, Numbe r:
Imll0rta nt Medica I Information:
Sociall Secu!ity Number:
Imll0rtant Medical Information:
Write down where your family spends the most time: work, school and otiher pl.aces you firequent. Schools, daycare providers, workplaces and
apartment buildings sho Id all have site-specific emergency plans that you and your family need to know about.
Work Location One
Address:
Phone Number:
.EvacuatiQn Location"
Work Location Two
Address'
Phone Number:
Evacuatioo Location=
Work Location Three
Address:
Phone Number:
Evacuation Location:
Other place you frequent
.Address-=-
Pho e NUlmber.:_
Evacuation Location:
School Location One
Address:
Phone Number:
Evacuation Location:
School Location Two
Addr.ess·
Phone Number:
EvacuatiQo Location=
School Location Three
Address:
Phone Number:
Evacuation Location:
Other place you frequent
Address:
Phone Number:
Blacuatio.o.Loc.ati.on:
Important Information
Name
Telephone Number
Policy Number
Doctor(s):
Other:
Pllarmacist:
Medical Insurance:
Hom eown ers/Ren ta I lin su ranee:
Veterina~ian/Kennel
(for pets):
Dial911 for Emergencies
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