REDUCE 9-1-1 DELAYS

This 5 Minute Task Could Save Your Life!

Providing 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As information changes over time, update individual forms, save and print the update and replace outdated sheets in your go-bag.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 Download Instructions Here Use only with a PDF reader, not in a browser.	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
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
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