Free Personal Emergency Plan Template
Personal Emergency Plan
Prepared by: [Your Name]
I. Personal Information
Name: Jollie Cassin
Address: Arlington, TX 76001
Emergency Contacts:
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Primary Contact: Ena Cassin (Spouse) – 555-123-4567
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Secondary Contact: Robert Smith (Neighbor) – 555-987-6543
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Emergency Services: 911
II. Emergency Contacts
A. Family and Friends
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Ena Cassin (Spouse) – 555-123-4567
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Sarah Johnson (Sister) – 555-234-5678
B. Professional Contacts
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Dr. Emily Brown (Primary Care Physician) – 555-345-6789
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Insurance Agent: Mark Lee – 555-456-7890
III. Medical Information
A. Medical Conditions
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Asthma
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High Blood Pressure
B. Medications
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Albuterol Inhaler: 2 puffs as needed for asthma attacks
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Lisinopril: 10 mg daily for high blood pressure
C. Allergies
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Penicillin
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Peanuts
D. Physicians
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Dr. Emily Brown (Primary Care Physician) – 555-345-6789
IV. Emergency Kit Checklist
A. Essentials
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Water: 1 gallon per person per day (3-day supply)
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Non-perishable food: Canned goods, protein bars
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Flashlight and extra batteries
B. Medical Supplies
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First aid kit
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Prescription medications
C. Miscellaneous
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Multi-tool
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Cash in small denominations
V. Evacuation Plan
A. Routes
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Primary Route: Main Street to Interstate 5
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Secondary Route: Backroads through Oak Avenue
B. Meeting Points
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Primary: Springfield Community Center
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Secondary: Neighbor’s house (Robert Smith)
C. Transportation Details
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Vehicle: 2050 Toyota Camry (full gas tank maintained)
VI. Communication Plan
A. During an Emergency
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Use text messages to conserve phone battery.
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Notify Jane Doe and Robert Smith of their current status and location.
B. After an Emergency
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Check-in with Sarah Johnson and other family members to confirm safety.
VII. Special Needs Considerations
A. For Individuals
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Asthma: Always carry an inhaler.
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High blood pressure: Maintain a 7-day supply of medication.
B. For Pets
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Dog (Buddy): Pack a 3-day supply of dog food, leash, and vaccination records.
VIII. Key Documents
A. Location of Documents
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Fireproof safe in the master bedroom closet.
B. Documents to Include
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IDs: Driver’s licenses, passports
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Financial Records: Bank statements, insurance policies
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Legal Documents: Will, power of attorney
C. Backup Copies
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Digital copies are stored on a password-protected USB drive.
