Free Emergency Plan

Answer a few simple questions Print and download instantly It takes just 5 minutes

Create Your Free Emergency Plan

  1. Answer a few simple questions
  2. Email, download or print instantly
  3. Just takes 5 minutes

Emergency Plan

Your Health Information


Your Health Information







Your Emergency Plan

This document preview is formatted to fit your mobile device. The formatting will change when printed or viewed on a desktop computer.
Page of

___________________________ EMERGENCY PLAN
9 November 2024

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

Name:
Mobile:
E-mail:

 

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)

   

[   ] Traveller'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 licences or identification cards

[   ] Health insurance cards

[   ] Tax file number

[   ] 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

[   ] ______________________________

[   ] ______________________________

[   ] ______________________________

[   ] ______________________________

[   ] ______________________________

[   ] ______________________________

Last Updated February 27, 2024

Emergency Plan Information

An Emergency Plan is also known as a/an:

  • Disaster preparedness plan
  • Home evacuation plan
  • Emergency response plan

What is an Emergency Plan?

Families use Emergency Plans to outline their actions in response to an emergency or natural disaster. With an established plan, each member of a household knows what to do, where to go, and who to contact in an emergency.

The key features of LawDepot’s Emergency Plan include:

  • Household contact information
  • Family member health information
  • Important contacts
  • Evacuation and shelter-at-home plans
  • Home preparation
  • Emergency items checklists

Why should I make an Emergency Plan?

Planning for potential risks and hazards speeds up your reaction time when a disaster hits. Creating an Emergency Plan also ensures that you have the necessities to get through a tough situation.

The region in which you live may be at higher risk of certain disasters or hazards than others. For example, Australia’s dry and hot climate makes it prone to bushfires and extreme heatwaves. Coastal homes are at risk of cyclones and shipwrecks hitting in the area. So, assess the potential threats in your area and plan accordingly.

It’s also important to think about any physical limitations that members of your family may have. Health conditions can affect your family’s ability to evacuate and take shelter. So, it helps to have a safety plan that works for everyone.

How do you write an Emergency Plan?

LawDepot’s template prompts you to include all of the key components of an emergency preparedness plan. Simply answer our questionnaire to add personalised details about your family members, house, and community. We’ll also guide you through the creation of different emergency responses such as evacuating, sheltering at home, and preparing your house systems.

Take the following steps to fill out the questionnaire and complete your custom Emergency Plan:

  • Gather important contacts’ phone numbers
  • Have relevant insurance policies handy (e.g., house or tenant insurance)
  • Sketch out your home’s floorplan (this is optional)
  • Research and decide on safe locations for your family to gather after an evacuation

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 to help you through these extra preparation tasks.

How do I plan for a home evacuation?

An effective evacuation plan includes planned emergency exits and designated safe spaces.

LawDepot’s Emergency Plan template prompts you to prepare a home escape route and attach it to your plan. Sketch the layout of your home (by hand or on the computer) and plan at least one or two exit options for every room in your house. Customise an escape route for various evacuation scenarios, such as blocked exits, heavy smoke, or fire in the house. If needed, prepare for exiting through windows with ladders or ropes.

Practice your evacuation plan with your family at least once every six months to a year. You may not have time to refer to your maps during an emergency, so it’s critical to learn and rehearse your escape routes ahead of time.

Our questionnaire will also prompt you to list two locations for meeting up with family members after an evacuation:

  • Outside your home: Choose a safe location that is outside your home but not directly beside it, such as the end of your driveway. You could also include city-designated storm shelter sites (such as community centres or churches) that are within walking distance. However, if you identify two safe spots outside your home, be sure your family knows which meeting place is appropriate for which type of emergency.
  • Outside your city: Choose an out-of-town location to meet during a city evacuation. Refer to your municipality’s evacuation plans to confirm what safety measures are in place during certain emergencies (roadblocks, for instance, may hinder you and your family from reaching a planned muster point). If needed, include instructions for different modes of transportation (like if you don’t have a car or run out of gas).

How do I plan 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 the potential risks to your specific community 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. In your plan, 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.

Our questionnaire will also guide you through an evaluation of your home’s mechanical systems. Knowing where valves and panels are, how to access them, and when to turn them on or off is important during emergencies. Generally, hazard proofing and keeping your house systems in good repair helps avoid further problems later.

How else can my family prepare for a disaster?

It’s important to involve the whole family in preparing for disasters. Conduct rehearsals for different evacuation scenarios, such as how to escape the house during a fire. Also, 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.

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 or injury. Check your roof, chimney, and drainage regularly. Keeping your house in good repair generally helps prevent further problems later.

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 heating systems, and how to turn them off when necessary.

Related Documents:

  • Last Will and Testament: Disasters may cause a sudden, unexpected loss of life. Create a Last Will to control the distribution of your estate once you pass away.
  • Power of Attorney: Appoint someone to act on your behalf if you become incapacitated or otherwise unable to express your wishes.
Emergency Plan Template Sample thumbnail

Sample

Emergency Plan

Personalise your Emergency Plan.

Print or download in minutes.

Create your free Emergency Plan today
This document preview is formatted to fit your mobile device. The formatting will change when printed or viewed on a desktop computer.
Loading ...
Loading ...

Note: Your initial answers are saved automatically when you preview your document.
This screen can be used to save additional copies of your answers.