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Emergency Plan

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An Emergency Plan ensures everyone in your household knows what to do in case of an emergency or disaster.




Your Emergency Plan

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___________________________ EMERGENCY PLAN
September 19, 2021

This Emergency Plan is a written set of instructions to help you and your household handle evacuation or shelter-at-home emergencies. It is recommended that you review your Emergency Plan on a regular basis, preferably annually, to ensure that all information is recent and up-to-date.

Contact Information

Member Name and Primary Information

Secondary Information

Availability

Name:
Mobile:
E-mail:

N/A

N/A

Name:
Mobile:
E-mail:

N/A

N/A



Evacuation Plans

  1. Home Escape Route

    A Home Escape Route has been prepared by the household and is attached to this Emergency Plan.

  2. Home Evacuation Instructions

    In case there is a need to evacuate the house, all household members must go here:  

  3. City Evacuation Instructions

    In case there is a need to evacuate the city, all household members must go here:  

  4. Urgent Evacuation Items

    In case you need to immediately evacuate, you should grab the following items:
    Emergency kits, _______________________________________________________________ 

  5. Non-Urgent Evacuation Items

    If you have extra time before you need to evacuate, you may want to take the following items with you:
      

  6. Evacuation Emergency Contact

    In case you need to evacuate, contact this person to inform them that you need to leave your home or city, and that you plan to travel to their place or intend to stay somewhere else (e.g. community shelters, etc.).

    1. Name: ___________________________
      Address: _________________________________________
      Contact Number: ___________________________
      E-mail Address: ___________________________

Shelter-At-Home Plans

  1. Safe Indoor Location

    In case there is a need to stay home during an emergency, all household members must go to: ________________________________________________

Home Preparation

  1. Home Mechanical Systems

    Mechanical System

    Location

    Utility Company

    Water Valve

     

    Company Name:
    Phone Number:

    Electrical Panel

     

    Company Name:
    Phone Number:

    Heating System

     

    Company Name:
    Phone Number:

    Floor Drain



     

EMERGENCY KIT CHECKLIST

Use this checklist to create and prepare your emergency kit. It is strongly recommended that your kit contains enough supplies to keep everyone in the household safe and comfortable for at least 72 hours. The kit should be in something that’s easy to carry, such as a backpack, and kept in an accessible place. It is also advised that each household member have their own emergency kit.

After preparing your emergency kit, inform everyone in the household where it can be found. Update your kit regularly (preferably every 6 months) to ensure the food and medications in your kit are not expired and your documents are still up-to-date.

FOOD AND WATER

Item

Quantity

Expiration Date and Other Details

[   ] Bottled water (1gallon/person/day)

   

[   ] Canned and dried foods

   

[   ] Protein or energy bars

   

[   ]

   

[   ]

   

[   ]

   

[   ]

   

MEDICAL ITEMS

Item

Quantity

Other Details
(description, expiration dates, etc.)

[   ] First aid kit

   

[   ] Non-prescription medication

   

[   ] Medical equipment, if any

   

[   ]

   

[   ]

   

[   ]

   

SAFETY ITEMS AND BASIC EQUIPMENT

Item

Quantity

Other Details
(description, expiration dates, etc.)

[   ] Battery-operated radio

   

[   ] Flashlight

   

[   ] Batteries

   

[   ] Candles, and matches or lighter

   

[   ] Whistle

   

[   ] Utility knife or pocket knife

   

[   ] Manual can opener

   

[   ] Utensils

   

[   ] Sewing kit

   

[   ] Duct tape

   

[   ]

   

[   ]

   

[   ]

   

CLOTHING AND TOILETRIES

Item

Quantity

Other Details
(description, expiration dates, etc.)

[   ] Toilet paper or moist towelettes

   

[   ] Hand sanitizer

   

[   ] Garbage bags and plastic ties

   

[   ] Change of clothing per member

   

[   ] Sleeping bag or blankets

   

[   ] Diapers, if needed

   

[   ]

   

[   ]

   

[   ]

   

CASH AND DOCUMENTS

Item

Quantity

Other Details
(description, expiration dates, etc.)

[   ] Folder of important documents

   

[   ] Cash (coins and small bills)

   

[   ] Traveler's cheques

   

[   ] Emergency Plan

   

[   ] Local maps

   

[   ]

   

[   ]

   

[   ]

   

IMPORTANT DOCUMENTS CHECKLIST

Use this checklist to create and prepare your important documents folder. Ensure you are prepared for any kind of emergency by creating copies of your important documents and compiling them in a folder or binder.

After compiling, it is highly recommended that you store your folder in your emergency kit.

PERSONAL DOCUMENTS

MEDICAL DOCUMENTS

[   ] Driver's licenses or identification cards

[   ] Health insurance cards

[   ] Social security cards/documents

[   ] Health, life, disability insurance policies

[   ] Passports

[   ] List of medications (OTC and prescription)

[   ] Birth or adoption certificates

[   ] Immunization or vaccination records

[   ] Last Will and Testament

[   ] ___________________________________

[   ] Living Will

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

   
   
   

PROPERTY DOCUMENTS

FINANCIAL DOCUMENTS

[   ] Mortgage documents

[   ] List of bank account numbers

[   ] Deeds, titles, leases for your home

[   ] List of investment account numbers

[   ] Deeds or titles for your vehicle

[   ] List of retirement/pension account numbers

[   ] Insurance policies

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________


FIRST AID CHECKLIST

Use this checklist to create and prepare your first aid kit. It is strongly recommended that your kit contains basic supplies needed to treat a variety of injuries. The kit should be kept together with your emergency kit.

After preparing your first aid kit, inform everyone in the household where it can be found. Update your kit regularly (preferably every 6 months) to ensure you have enough supplies and any medication you included is not expired.

BURNS

MEDICATION

[   ] Burn gel

[   ] Antihistamine

[   ] Burn dressing (4"x4")

[   ] Antacid tablets

[   ] ___________________________________

[   ] Aspirin, Ibuprofen or Tylenol

[   ] ___________________________________

[   ] Oral pain gel

[   ] ___________________________________

[   ] Cold relief medicine

 

[   ] Rehydration pills or electrolytes replenisher

CUTS OR WOUNDS

[   ] Muscle relaxer

[   ] Regular bandages (different types & sizes)

[   ] Sleep aid

[   ] Gauze dressing pads (2"x2" or 4"x4")

[   ] Motion sickness relief

[   ] Trauma pads

[   ] ___________________________________

[   ] Band aids

[   ] ___________________________________

[   ] Nylon sutures

[   ] ___________________________________

[   ] Surgical scissors

 

[   ] Adhesive tape

OTHER

[   ] Tweezers

[   ] Thermometer

[   ] ___________________________________

[   ] Towel

[   ] ___________________________________

[   ] Antiseptic wipes or soap

[   ] ___________________________________

[   ] Eyepads

 

[   ] Gloves

SPRAINS

[   ] Safety pins

[   ] Finger splint

[   ] Ziplock bags

[   ] Flexible splint

[   ] Blanket

[   ] Elastic bandages

[   ] First aid manual

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

[   ] ___________________________________

Emergency Plan Information

An Emergency Plan is also known as a/an:

  • Emergency action plan
  • Emergency preparedness plan
  • Disaster response plan
  • Safety plan

What is an Emergency Plan?

An Emergency Plan is a central document that household members use to outline their actions in response to an emergency or natural disaster. By creating and referencing this document, each member of your family will know what to do, where to go, or who to contact in an emergency.

The key features of LawDepot’s Emergency Plan include:

  • Details about the members of your household (e.g., contact numbers, health insurance, and medications)
  • Numbers of emergency contact people and services (e.g., local fire station, nearest hospital, or poison control)
  • Processes for evacuation (e.g., escape routes, essential items, and safe places)
  • Guidelines for sheltering at home (e.g., details about mechanical systems and safety equipment)
  • Checklists for essential items

Why should I make an Emergency Plan?

Although the general consequences of disasters can be similar, the region in which you live may be more susceptible to certain risk factors than others. For example, coastal states are prone to suffer from hurricanes and floods, while other regions may be at risk of industrial or transportation accidents.

Likewise, individual members of your family may have health conditions or disabilities that will affect how your household responds to an emergency. For instance, if you need to evacuate and a member of your family is physically disabled, you’ll need to plan an escape route that everyone can safely navigate.

As such, it’s important to assess the risks that you face at home and make a personalized Emergency Plan to protect your loved ones from harm. This proactivity not only speeds up your reaction to an emergency but also ensures that you have the necessities to get through a tough situation.

How do you write an Emergency Plan?

Your family Emergency Plan should include personalized details about your family members, house, and community. It should also clearly outline different emergency responses, such as evacuating, sheltering at home, and preparing essential items.

Planning for evacuations

Our template prompts you to include a home escape route, which is a floor plan of your home that shows possible ways to escape from every room. You can draw this floor plan by hand or on the computer.

If needed, prepare to escape from windows with ladders or ropes and add instructions for doing so. Consider how evacuation routines may differ depending on the emergency, such as a fire, flood, blocked exit, or separation of family members. Account for the physical needs of each family member and plan escape routes that everyone can navigate safely.

After you evacuate your home, meet your family members in a safe location. Our questionnaire asks you for meeting areas both outside your home and outside your community. Some municipalities may designate storm shelters when needed, but you can also choose your own meeting points.

Planning for sheltering at home

Severe weather, industrial accidents, or public health emergencies may call for people to shelter in place (i.e., stay indoors) until the danger recedes.

Again, it’s important to assess all potential risks to your community in particular and plan accordingly. LawDepot’s Emergency Plan template prompts you to consider a safe indoor location, but where you go inside your house to wait out the danger will vary depending on the circumstances.

For instance, if there is a tornado or earthquake, go to your basement or seek shelter under a table. Add instructions for closing doors and windows to cut off ventilation if there is a nuclear or chemical accident. Learn how to insulate and heat your home safely in case of a winter power outage.

Preparing essential items

In addition to your Emergency Plan, it’s also important to prepare essential items and documents (such as a first aid kit, an emergency items kit, and photocopies of IDs, insurance policies, etc.). Our template includes checklists that will guide you through these extra preparation tasks.

When should I use my Emergency Plan?

Local authorities will notify you if an emergency requires you to evacuate or shelter at home. This could be in response to natural disasters or human-caused hazards such as fires, floods, extended power outages, civil unrest, and more. In emergency situations, take these steps:

  • Follow your Emergency Plan
  • Grab your emergency kits
  • Ensure your own safety before helping others
  • Listen for more information from local officials

How else can my family prepare for a disaster?

Taking steps to prepare your family and home ahead of a disaster will improve your chances of success when it’s time to act.

LawDepot’s Emergency Plan template will prompt you to consider the mechanical systems in your home. You should know the locations of important systems, such as electrical panels and gas valves, and how to turn them off when necessary.

You can also hazard-proof your home for environmental risks in your area. For instance, remove chemical products and irreplaceable belongings from the basement in case of a flood. If you’re in a place that’s prone to earthquakes or tornados, be sure to secure any objects that could fall and cause damage. Check your roof, chimney, and drainage regularly. Keeping your house in good repair generally helps avoid further problems later.

It’s important to involve the whole family in preparing for disaster. Conduct rehearsals for different evacuation scenarios (such as how to escape the house during a fire) and assign family members specific duties (such as gathering pets, performing first aid, or purifying water).

Be sure to review your plan and maintain your emergency kits regularly, at least every six months to a year.

What do I do after a disaster?

Once you’ve executed your Emergency Plan and ensured the safety of your household, you can:

  • Take steps to help any other injured people nearby.
  • Listen to the media to keep tabs on the on-going response effort.
  • Reunite with your extended family or other people who are important to you.
  • When it’s safe, check your home for other hazards and restore the power if needed.

Major disasters often leave people feeling helpless, worried, angry, or apathetic. However, it’s important to take care of your mental and physical well-being during these times. If you or your family experience severe emotional reactions or physical symptoms from the disaster, you may want to seek help from your family doctor, counselor, or another helpful community agency.

Related documents

  • Just-in-Case Instructions: While an Emergency Plan suits family households, these instructions have less focus on disaster response and better suit people who live alone.
  • Last Will and Testament: Disasters may cause a sudden, unexpected loss of life. Use a Last Will to control the distribution of your estate once you pass away.
  • Living Will: Give consent to certain medical treatments in advance for when something leaves you incapacitated or unable to express your wishes.
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