Form: Make an emergency plan

This form will help you create your home emergency plan. It should only take about 20 minutes to complete. There are eight easy steps. Even if you are uncertain about how to answer some of the sections, skip to the next section. Once finished, you will have a document that you can download to your computer to be saved, printed or updated. You can always add more information later to any sections you may have skipped. You may also check with your local government authorities for existing plans to use as a reference.

Once completed, make sure everyone in your home knows and keeps the plan in an easy-to-find, easy-to-remember place (with your emergency kit, for example). Make sure you share your emergency plan with your friends, family, and neighbors, and encourage them to do the same. You may also want to make duplicate copies to keep in your car and at work.

Enter a title for your plan (For example your family name):

Step 1 - Identify escape routes

Plan emergency exits from each room of your home. Try to think of two possibilities for each room. If you live in an apartment, do not plan to use the elevators. Also, identify an escape route from your neighbourhood in case you are ordered to evacuate.

Escape route from neighbourhood:

Step 2 - Establish meeting places

Safety tip: Whenever possible, the meeting place should be on the same side of the street as your home. This way you don't need to cross the street into traffic or in front of fire trucks or ambulances during an emergency.

Meeting place near your home:

Meeting place outside of your immediate neighbourhood:

Step 3 - Plan for children

If an emergency occurs during school hours, you may need someone else to pick up your children from daycare or school. Make sure the school or daycare has up-to-date contact information for both yourself and other adults whom you have authorized on the pick-up list.

Designated person 1: Phone:

Designated person 2: Phone:

Instructions for school pick-up (ex: Meeting place):

Step 4 - Address any special health needs

Safety tip: Establish a support network of friends, relatives, health-care providers, co-workers and neighbours who understand your special needs. Write down details below about your medical conditions, allergies, surgeries, family medical history, medications, health screenings, recent vaccinations, emergency contacts and insurance information. Include household members' special needs as well.

Health information:

Medications and medical equipment:

Pharmacies may be closed for some time, even after an emergency is over. Consider talking to your doctor about having an extra two-week supply of medications and medical supplies on hand if possible. Include prescriptions, medical documents and the health information above that you can put into your easy to carry emergency kit.

Identify a location for your emergency kit:

Step 5 - Plan for pets

Now that you have made emergency plans for your family and friends, don't forget about your pets.

The most important thing you can do to protect your pets is to take them with you if you need to evacuate. This requires advance planning as pets are not allowed in some public shelters or hotels. Plan to take your pets with you to a relative or a friend's home, or identify a "pet-friendly" hotel, boarding facility or emergency shelter in advance.

Location for pet during an emergency:

Step 6 - Plan for specific risks

What should you do in case of an earthquake? Flood? Power failure? Write down instructions for the risks that are most likely to occur in your region.

Instructions:

Step 7 - Record emergency contact information

Remember, your family may not be together when a disaster occurs. Plan how to meet or contact one another. Discuss what you would do in different situations. If you are trying to contact others, use non-voice channels like text messaging, email or social media if possible, as these use less bandwidth than voice communications and may continue to work even when phone service has been disrupted.

Local Emergency Numbers

Fire:

Police:

Ambulance:

Other:

Family contacts

Name:

Phone (Home):

Phone (Work):

Phone (Cell):

Email:

Home Address:

Name:

Phone (Home):

Phone (Work):

Phone (Cell):

Email:

Home Address:

Out-of-town Contact

In the event of an emergency, each family member should call or e-mail the same out-of-town contact person. Choose a contact person who lives far enough out of town that he or she will most likely not be affected by the same event. If you are new to Canada or do not have an out-of-town contact person, make arrangements through friends, cultural associations or local community organizations.

Name:

Phone (Home):

Phone (Work):

Phone (Cell):

Email:

Home Address:

Friends/Neighbours

Once you're safe, check on vulnerable family members, friends, neighbours or those in your community that may need additional assistance.

Name:

Phone (Home):

Phone (Work):

Phone (Cell):

Email:

Home Address:

Family Doctor

Patient's Name:

Doctor's Name:

Phone:

Patient's Name:

Doctor's Name:

Phone:

Non-emergency Numbers

Fire:

Police:

Health Clinic:

Other:

Insurance Agent/Company

Name:

Phone:

Step 8 - Complete safe home instructions

Make sure you have a working smoke detector and fire extinguisher. If you live in an apartment or are staying in a hotel, know where the fire alarms are located. Complete the following section so your family or roommate(s) know where these items are located in case of an emergency:

Emergency Kit

Location:

Fire Extinguisher

Location:

Water Valve

Location:

Shut-Off Instructions:

Applicable Phone Number:

Electrical Box

Location:

Applicable Phone Number:

Heating Source (Gas Valve, Propane, Oil)

Location:

Shut-Off Instructions:

Applicable Phone Number:

Additional Utility Equipment (ex: Solar Panels, Sump Pump)

Equipment:

Location:

Shut-Off Instructions:

Applicable Phone Number:

Floor Drain

(Always ensure it is clear of boxes, clothes or furniture, in case there is a flood.)

Location:

Page details

2025-09-12

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Form: Make an emergency plan

Step 1 - Identify escape routes

Step 2 - Establish meeting places

Step 3 - Plan for children

Step 4 - Address any special health needs

Step 5 - Plan for pets

Step 6 - Plan for specific risks

Step 7 - Record emergency contact information

Step 8 - Complete safe home instructions

Page details

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