REDUCE 9-1-1
DELAYS
This 5
Minute Task Could Save Your Life!
FAMILY EMERGENCY RECORDS
Download Family Emergency
Retention Forms Below
Family information recorded in a safe location
can greatly assist your disaster recovery efforts.
Don't Wait
– Communicate Now!
Fill-in the Blanks, Save and Print.
Store in a safe location.
Open Source Downloadable Forms Below.
With little notice we can be displaced or isolated because of fire, flood, tornado, hurricane, chemical spill, earthquake, avalanche, tsunamis or act of terrorism. Reconstructing your life after a disaster can be an exhausting, expensive and a lengthy task. Your disaster resistance to these events can be increased through preparation by providing important personal information in your go-bag. Access to this information immediately after an emergency will greatly assist the reconstruction of your life as it was previously. Instructions: Download individual forms or the combo pack (all forms) and save each form with a name specific to you or your family. Each family member may want their own form. Every form includes a 'save as' button and a 'print' button. You may require additional pages for some categories so each form includes 'page___ of ___' for easy organization. Then save and print each form and place in a soft cover binder or pouch for inclusion in your go-bag. As information changes over time, update individual forms, save and print the update and replace outdated sheets in your go-bag. Take steps to keep this electronic and printed information safe and secure.
Click Title to Download
a Form |
Comments |
Data Retention Forms (Combo Pack) Zip, 1 MB |
All forms listed below |
Alternate Key Holder Form | Provide a readily available house key via an alternate key holder, registered with the 9-1-1 center, to provide quick and non intrusive entrance into your home. When you call 9-1-1 for service, often emergency services will have a need to enter you home quickly. When you are not able to unlock your entry door or not at home (such as a fire alarm), what will they do? They look for an unlocked door, an open window or another non intrusive entry point. When time is critical they may proceed with a trained procedure called "forced entry." |
Alternate Key Holders
Information Sheet |
Complete this form and provide to your alternate key holder so they can provide info to first responders if you are unable or not available. |
Codes, IDs and Passwords | Our life is governed by IDs and Passwords. Have them readily available in a Grab & Go format |
Contact Us Through These People |
List the people or organizations through which you can be contacted in times of an emergency |
DIY Form | Open format, design you own. |
Education | Employment, licenses and permits may depend on accurate education records |
Employment | Knowing your employment history can be critical to gaining future employment. |
Emergency Medical Data | Pre-record your medical history for rapid access by responders |
Family | Record accurate and complete contact information for your family |
Family Emergency Communication Plan | Contact card for each family member. Keep these cards with you at all times. From CDC Emergency Preparedness and Response |
Financial Assets | Access may depend on knowing account numbers for banks, savings, investments, property etc. Automatic renewal may need canceling after an emergency |
Health Care | List your Medical Doctors, Dentist, Therapist, Alertest, Pediatrician or other health care professionals |
Income Sources | Often required to redirect payments following the emergency |
Insurance | Often required immediately following the emergency |
Legal Documents | What and where are they |
Licenses, Permits and Authorizations | What are they and when is renewal. Accurate information can be critical to gaining future employment. |
Memberships | Where are you member and the contact information |
Notification Upon Death | Complete your own list using this form. Because many people, organizations, and financial obligations require notification upon death, here are two excellent checklist from the National Funeral Directors Association and a document prepared for the State of Washington by Legal Voice.org |
Personal Data | Includes personal information necessary to reconstruct your life |
Phone List | You may require multiple pages to complete your list |
Physical Assets | What and where are they? Particularly off-site assets like condos, boats, campers, cottage, storage units, vehicles, |
Resident Locations | Where have you lived thus far in your life |
Utility Locations | Exact location knowledge can greatly assist rapid shut-off |
Utility Providers | Quick contact may be required immediately following the emergency |
Watch
How to Reduce 9-1-1 Delays!
Documents to Reduce 9-1-1 Delays The information,
documents and downloads on this website are open source and free to download
and use for your organization. Under no circumstance are they to be sold or
used to make a profit. All Rights Reserved - Lee Hite
Reduce 9-1-1
Delays (Checklist)
Items for
the 9-1-1 Premise Page
Emergency Medical Data
Sheet English
9-1-1 Addressing That Works
Emergency Medical Data
Sheet Spanish
Emergency Shut-Off Signage
Emergency Medical Data
(Long Form English)
Healthy Hydrants Guideline
Emergency Medical Data
(Example)
It's Okay to ASK
Alternate Key Holder
Registration
Sirens & Lights Guidelines
Alternate Key Holder
Information
Family Records Retention
Forms
Become a Helpful Responder – Not a Helpless
Bystander