Family Disaster Plan

Wilson County 2011

Note: It is important to store this document in a secure location to reduce the risk of losing personal information that could lead to possible ID theft and fraud. In addition, this document should be stored in a water tight container and on a computer disk.

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About your Family Disaster Plan This booklet is a plan template and is intended to give you a format and possible suggestions about information you might want to include in a family disaster plan. It is not all inclusive and should be modified by the user as needed. Each individual or family should adapt this plan to their specific needs or requirements

Update and review plan

Last Update

Next Update

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Household Members Household Members

Relation/Birthday

Social Security No.

Pets

Pet Rabies Vaccination Number

Vet Name and Number

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Household Information Home Address:______________________________________________________ Phone 1_____________________________ Phone 2_______________________ Email 1 ______________________________________________________________ Email 2 ______________________________________________________________

Car Information: Make

Model

Year

License #

Emergency Numbers Call 911 for EMERGENCY (Note: After a disaster, 911 may not be working. Use Numbers you listed below) Department Fire Police Ambulance Poison Control Hospital Emergency Room Pharmacy

Name

Phone #

Date confirmed

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Primary Care Doctor Psychiatrist Provider Agency Therapist

Insurance/Medicaid Number/Other Information (health, auto, home, and life) Name/Company

Type of Coverage

Policy Number

Phone

NOTES

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Household Members Medication List User’s Name

Medication Name

Dosage/Frequency

Reason for Taking

Doctor

Prescription #

Date Start/End

Location of Meds

Pharmacy Phone #

User’s Name

Medication Name

Dosage/Frequency

Reason for Taking

Doctor

Prescription #

Date Start/End

Location of Meds

Pharmacy Phone #

User’s Name

Medication Name

Dosage/Frequency

Reason for Taking

Doctor

Prescription #

Date Start/End

Location of Meds

Pharmacy Phone #

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User’s Name

Medication Name

Dosage/Frequency

Reason for Taking

Doctor

Prescription #

Date Start/End

Location of Meds

Pharmacy Phone #

User’s Name

Medication Name

Dosage/Frequency

Reason for Taking

Doctor

Prescription #

Date Start/End

Location of Meds

Pharmacy Phone #

User’s Name

Medication Name

Dosage/Frequency

Reason for Taking

Doctor

Prescription #

Date Start/End

Location of Meds

Pharmacy Phone #

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Allergies to Medication/Food/Other Family Member’s Name

Medication

Food

Other

Health/Disability Information Family Member’s Name

Health Problem /Disability

Special Needs, Equipment, and Supplies Family Member’s Name

Special Needs/ Equipment/Supplies

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Contacts Utility and Service Name

Address

Phone Number

Water

Electric

Gas

Phone

Cable

Medical

NOTES

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Know What to Do in Case of Emergency It is important to make sure that the entire family is prepared and informed in the event of a disaster or emergency. You may not always be together when these events take place and should have plans for making sure you are able to contact and find one another.

The American Red Cross suggests some basic steps to make sure you remain safe: 

Meet with your family or household members.



Discuss how to prepare and respond to emergencies that are most likely to happen where you live, learn, work and play.



Identify responsibilities for each member of your household and plan to work together as a team.



If a family member is in the military, plan how you would respond if they were deployed.

Plan what to do in case you are separated during an emergency 

Choose two places to meet: ▸ Right outside your home in case of a sudden emergency, such as a fire ▸ Outside your neighborhood, in case you cannot return home or are asked to evacuate



Choose an out-of-area emergency contact person. It may be easier to text or call long distance if local phone lines are overloaded or out of service. Everyone should have emergency contact information in writing or saved on their cell phones.

Plan what to do if you have to evacuate 

Decide where you would go and what route you would take to get there. You may choose to go to a hotel/motel, stay with friends or relatives in a safe location or go to an evacuation shelter if necessary.



Practice evacuating your home twice a year. Drive your planned evacuation route and plot alternate routes on your map in case roads are impassable.



Plan ahead for your pets. Keep a phone list of pet-friendly hotels/motels and animal shelters that are along your evacuation routes.

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Let Your Family Know You're Safe If your community has experienced a disaster, register on the American Red Cross Safe and Well website to let your family and friends know you are safe. You may also call 1-800-RED CROSS (1-800-733-2767) and select the prompt for "Disaster" to register yourself and your family.

Robeson Co. 2011

IMPORTANT It is important to have a place to meet if roads are impassable to your house. (Such as the Wal-Mart parking lot,middle school, etc.)

If we can’t get home, our designated place to meet is:

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Sampson Co. 2011

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Family/Friends/Neighbors (Identify two neighbors. Name

Address

Phone

Agree to check on each other)

Email

Out-of –Area Contact (During Disasters, use phones for ER only.

Cell Phone Number

Local phone lines

may be tied up. Make one call to your out-of-area designee to report in. Let this person contact others) Name

Address

Home Phone #

Cell Phone #

Email

NOTES

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Home Layout/Diagram

Draw a layout of your home. Make sure you include locations of utility shutoffs and safety equipment like fire extinguishers, disaster supplies, evacuation plans, etc. 14 | P a g e

Utility Control

Electricity: In the event that you need to turn off the electricity in your house, go to the breaker box and do the following: 1) Turn off the smaller breakers one by one 2) Flip the “main” breaker last. To reenergize your home, reverse the pervious steps. Water: In the event you need to shut water off inside your home, find the main water valve and turn it to your right. To open the flow of water back into the house, turn it to your left. Gas: IMPORTANT - Only turn off your gas at the meter if you smell gas! To turn off natural gas in your house, take a wrench and tighten it on to the quarter turn valve that is on the pipe that feeds into the gas meter. Turn it one quarter turn to make the indicator parallel to the ground. In most locations, once you do this you cannot turn the gas back on to the house without the utility company. Propane: If you live in an area that uses outdoor propane or LP Gas you will find this outside the home. Open the top of the tank and you will see either a regular turn knob or a quarter turn value. Turn the knob to your right to shut off the flow of propane into your house. For quarter turn valve see above. Portable Electric Generator: Using a generator indoors CAN KILL YOU IN MINUTES. Exhaust contains carbon monoxide, a deadly poison gas you cannot see or smell. Be sure to read and adhere to the manufacturer's directions for safe operation. Never use a generator indoors or in an attached garage and don't connect your generator directly to your home's wiring. Do not plug a portable generator into an electrical outlet in your home or garage. It can still 'back feed' power into the utility company lines, which can injure or kill utility workers fixing on the downed power lines. And make sure your generator is properly grounded to avoid electrical shocks.

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Disaster Supply Kit □ Water – at least 1 gallon daily per person for 3 to 7 days □ Food – at least enough for 3 to 7 days ▪ Non-perishable packaged or canned food/juices ▪ Foods for infants or the elderly ▪ Snack foods ▪ Non-electric can opener ▪ Cooking tools/fuel ▪ Paper plates/plastic utensils

□ Blankets / Pillows □ Clothing –seasonal/raingear/sturdy shoes □ First Aid Kit/Medicine/Prescription drugs □ Special items – for babies, the elderly, and for pets □ Toiletries/Hygiene items/Moisture wipes □Flashlight/Batteries /Radio- Battery operated and NOAA weather radio □Cash (with small bills) ▪ Banks and ATMs may not be open for extended periods

□ Keys □ Toys, Books and Games □ Important Documents (in a waterproof container) □ Tools – keep a set with you during the storm □ Vehicle fuel tanks filled 16 | P a g e

NOTES

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This booklet was provided by Eastpointe MCO. For Behavioral Health Services please call 800-913-6109

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