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This Disaster Planner Belongs To :

_______________________

_______________________

Address:

_______________________

_______________________

_______________________

Phone:

_______________________

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Family Information

Name

_______________________

Birthdate

_______________________

Race

_______________________

Eye Color

_______________________

Height and Body Build

_______________________

Hair Color

_______________________

Notable Features -(birthmark, tattoo, scar)

_______________________

Medical Conditions

_______________________

_______________________

_______________________

Work/School Phone #

_______________________

Record Mobile Phone

_______________________

Attach Family Photo or aPhoto of Each FamilyMember

Contact Information ofNearest (Next of Kin)Relative

______________________________________________

Other Information

_______________________

_______________________

Name

_______________________

Birthdate

_______________________

Race

_______________________

Eye Color

_______________________

Height and Body Build

_______________________

Hair Color

_______________________

Notable Features -(birthmark, tattoo, scar)

_______________________

Medical Conditions

_______________________

_______________________

_______________________

Work/School Phone #

_______________________

Record Mobile Phone

_______________________

Attach Family Photo or aPhoto of Each FamilyMember

Contact Information ofNearest (Next of Kin)Relative

_______________________

_______________________

Other Information

_______________________

_______________________

Name

_______________________

Birthdate

_______________________

Race

_______________________

Eye Color

_______________________

Height and Body Build

_______________________

Hair Color

_______________________

Notable Features -(birthmark, tattoo, scar)

_______________________

Medical Conditions

_______________________

_______________________

_______________________

Work/School Phone #

_______________________

Record Mobile Phone

_______________________

Attach Family Photo or aPhoto of Each FamilyMember

Contact Information ofNearest (Next of Kin)Relative

_______________________

_______________________

Other Information

_______________________

_______________________

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EMERGENCY CONTACT

Neighborhood Contact

Name ________________________________________________________________________

Address ______________________________________________________________________

Relation ______________________________________________________________________Phone ________________________________________________________________________

Email ________________________________________________________________________

Out of Neighborhood Contact

Name ________________________________________________________________________

Address ______________________________________________________________________

Relation ______________________________________________________________________

Phone ________________________________________________________________________

Email ________________________________________________________________________

Out of State Contact

Name ________________________________________________________________________

Address ______________________________________________________________________

Relation ______________________________________________________________________

Phone ________________________________________________________________________

Email ________________________________________________________________________

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important numbers

Attorney Name ___________________________ # ___________________________

Doctor Name ___________________________

Whos Doctor _______________________ #_________________________

Doctor Name ___________________________

Whos Doctor _______________________ # ________________________

Doctor Name ___________________________

Whos Doctor _______________________ # ________________________

Local Hospital Main # _______________________________________

Electrician Name ___________________________ # ___________________________

Home Insurance Company____________________________ # __________________________

Car Insurance Company _____________________________ # ___________________________

Health Insurance Company __________________________ # ___________________________

Local Municipality Phone #(city hall, town clerk) _________________________________

Plumber Name ___________________________ # ________________________________

Poison Control ______________________________________

Alarm Company ____________________________ # ____________________________

Bank Contact Name ____________________________ # __________________________

Emergency Contact ___________________________ # _____________________________

Veterinarian Name __________________________ # ______________________________

Local Office of Emergency Management _________________________________

Fire Department ____________________________________________________

Light Company Phone ____________________________________

Water Company Phone ___________________________________

Gas Company Phone _____________________________________Kennel Phone # _____________________________________

Police Station # _____________________________________

Number for Local Red Cross ______________________________

Number for FEMA ______________________________________

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INSURANCE Information

Life

Policy Holder _________________________

Policy Number ________________________

Insurance Company Phone Number ___________________________Medical

Policy Holder _________________________

Policy Number ________________________

Insurance Company Phone Number ___________________________

Home

Policy Holder _________________________

Policy Number ________________________

Insurance Company Phone Number ___________________________

Car

Policy Holder _________________________

Policy Number ________________________

Insurance Company Phone Number ___________________________

Other_____________

Policy Holder _________________________

Policy Number ________________________

Insurance Company Phone Number ___________________________

Other ____________

Policy Holder _________________________

Policy Number ________________________

Insurance Company Phone Number ___________________________

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FAMILY Records

Family Records - includes documents that are important and hard to replace. Each of these itemsshould be copied. We advise that originals are kept in a safety deposit box or a safe in the home.

Before it is stored it should be placed in a watertight container such as Doc-u-Keeper. These

items include:

Copy of Drivers LicenseBirth Certificate and Marriage Certificates and Death Certificates

Social Security Cards

Medical and Dental Cards

Insurance Policies with Information

Passports

Diplomas and Degrees

Home Mortgage Documents or Deeds

Vehicle Titles and Registration

Home Inventory

Income Tax Records(first two pages)

Stock Certificates/ Bonds/ Notes

Citizenship and Naturalization Papers

Credit Card/ Loan Contact Information

Wills and Legal Documents

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AREA RISK

List the Top Disasters You Regularly Have In Your Area

1.__________________________

2. _________________________

3. _________________________

4. _________________________

5. _________________________

List 3 Designated Reunion Location

In Home Location _____________________________________

In Neighborhood Location ______________________________________

Out of Neighborhood Location(local park, school) __________________________________

Shelter in Place

Stay in an interior room of your home

Which room ______________________________

Move your supplies to this room

Camp out until the disaster is over and it is safe

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floor plan

Create a floor plan. Create a key and mark in the locations of your emergency supplies, your

utilities, your safety equipment, and exits.

First Floor

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Second Floor

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disaster PLANS

Make a Plan for the Top 5 Disasters You are at Risk

Disaster

_____________________________________

After a Disaster we will:

Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

Before a Disaster we will:

Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

6.____________________________________________________________________________

During a Disaster we will:

Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

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Disaster___________________________

Before a Disaster we will:

Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

6.____________________________________________________________________________

During a Disaster we will:

Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

After a Disaster we will:Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

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Disaster___________________________

Before a Disaster we will:

Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

6.____________________________________________________________________________

During a Disaster we will:

Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

After a Disaster we will:

Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

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Disaster___________________________

Before a Disaster we will:

Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

6.____________________________________________________________________________

During a Disaster we will:

Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

After a Disaster we will:Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

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Disaster___________________________

Before a Disaster we will:

Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

6.____________________________________________________________________________

During a Disaster we will:

Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

After a Disaster we will:

Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

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EVACUATION PLAN

Where will you go (Option 1):

_________________________________________________________________

_________________________________________________________________

Where will you go (Option 2):

_____________________________________________________________________________

_____________________________________________________________________________

Create an action plan to complete the steps below:

List of What to Pack

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

List to Get Your Vehicle Ready

_______________________________________

_______________________________________

________________________________________

________________________________________

________________________________________

________________________________________

________________________________________

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List to Secure Your Home

________________________________________

________________________________________

________________________________________

________________________________________

________________________________________

________________________________________

Returning Home

When it is safe, return home

Document any damage (with pictures also)

Home Inventory

Keep a copy of your home inventory in one or all of your disaster planners.

VEHICLE INFORMATION

YEAR MAKE MODEL LICENSE

PLATE

VIN #

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PETS

Name __________________________________

Species _________________________________

Breed __________________________________

Description ______________________________

Special Needs ____________________________

Veterinarian ______________________________

Immunization Records

Photo

Name __________________________________

Species _________________________________

Breed __________________________________

Description ______________________________

Special Needs ____________________________

Veterinarian ______________________________

Immunization Records

Photo

Name __________________________________

Species _________________________________

Breed __________________________________

Description ______________________________

Special Needs ____________________________

Veterinarian ______________________________

Immunization Records

Photo

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disaster supplies inventory

Inventory your disaster supplies by recording the location, the item, and the amount of your

disaster supplies.

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LIVING ROOM

KITCHEN

GARAGE

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mASTER BEDROOM

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