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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
October 17, 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)

   

[   ] 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

[   ] Social insurance 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 an:

  • Emergency response plan
  • Emergency action plan
  • Emergency and disaster management plan

What is an Emergency Plan?

An Emergency Plan outlines your household’s actions in response to a local emergency or natural disaster. With a clear plan, each member of your family speeds up their reaction to an immediate threat such as a natural disaster (like a flood, fire, or extreme weather) or human-caused hazard (such as a chemical spill or transportation accident).

Emergency situations may call for you to evacuate your area or take shelter at home. An Emergency Plan is a valuable tool for assessing the potential risks in your environment and planning your response to them ahead of time.

The essential components of LawDepot’s Emergency Plan template include:

  • General information about your household (medical histories and insurance policies)
  • Contact details for key people and services
  • Processes and guidelines for evacuation and sheltering at home
  • Emergency preparedness checklists (documents, first aid, and essential items)

Why should I create an Emergency Plan for my family?

Creating an Emergency Plan ensures that you and your loved ones have the knowledge and the necessities to get through tough situations.

Depending on where you live, you may be more susceptible to certain risk factors than others. Some regions may be at a higher risk for extreme cold and extended power outages, while others may be prone to wildfires or flooding. So, it’s important to assess potential threats and make a personalized Emergency Plan to protect yourself and your loved ones from harm.

Local authorities may or may not have resources available to aid the public during certain emergency responses (like having enough firefighters to deal with a rapidly spreading wildfire). Knowing the foreseeable threats your community faces and how it can respond to them will help you determine your personal responsibilities during a crisis.

You should also consider any health conditions or disabilities that will affect how individual family members can respond to an emergency. For example, if you need to evacuate and a member of your family is living with a physical disability, you’ll need to plan a route that everyone can safely navigate.

How do I write an emergency evacuation plan?

LawDepot’s Emergency Plan template prompts you to prepare a home escape route and attach it to your plan.

Customize an escape route for various evacuation scenarios, such as blocked exits, heavy smoke, or fire in the house. Sketch the layout of your home and plan for at least one or two exit options for every room in your 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, like 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’re identifying 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 may be in place during certain emergencies (roadblocks, for instance, may hinder your family from reaching their 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).

What does an emergency kit include?

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

When assembling emergency kits, use backpacks or containers that are easy to grab and go. Each kit should include essential items to help you get through at least 72 hours without access to services. You can create a large family kit, but individual kits are easier to transport and helpful if family members get separated.

Our emergency kit checklist reminds you to pack essentials such as:

  • Food and water
  • Medical items
  • Safety items and basic equipment
  • Clothing and toiletries
  • Cash and documents

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 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.

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 do I prepare my family for different emergencies?

There are several steps you can take to prepare your family for different emergencies:

  • Discuss your Emergency Plan in-depth with each family member.
  • Conduct rehearsals for different evacuation scenarios.
  • Assign family members specific duties (e.g., gathering pets, performing first aid, or purifying water).
  • Review your plan and emergency kits every six months or once a year.

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.
  • Personal Directive: Give consent to certain medical treatments in advance for when something leaves you incapacitated or unable to express your wishes.
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