Emergency Planning Document (Fillable)
One page that helps others help you if you are ill or away. Keep it updated and tell a trusted contact where it is.
My key contacts
Name: ____________ Phone: ____________ Doctor: ____________
Pharmacy: ____________ Power of attorney: ____________
My meds & conditions
Condition / med / dose: ____________
Condition / med / dose: ____________
Important papers (where they are)
- ID & insurance: ____________
- Will: ____________
- Deeds & accounts: ____________
- Emergency cash: ____________
Evacuation plan
If I must leave: go to ____________ Out-of-area contact: ____________
Practical tip: Store a paper copy in a clearly labeled envelope and a photo of it in your phone – both, not just one.