Family Emergency Planning
Turning Point Center for Youth & Family Development is part of Colorado Department of Health & Environment’s Disaster Behavioral Health Initiative. The following is a helpful tool and template for preparing families for disaster.
Here is a link to a downloadable template: https://drive.google.com/file/d/1yl8YXS-CK07lA0QqiaY_sq2C7k1DRVvs/view
Disasters can occur any day or time. It is important to plan ahead of time because you may not be with or near your support system when a disaster occurs. Knowing the connections within your community network are key to recovery. Additionally, it is essential to include behavioral health as part of your preparedness plan to help reduce stress and increase your ability to function in an emergency. Having a well-developed plan can help with reunification and keep your daily needs as close to pre-disaster as possible.
Family Name:
Home Address:
Phone Numbers:
Primary Language Spoken:
Medication and medical treatment
It is important to have medical information written down for those who are not familiar with your medical history and may be supporting you in the time of a disaster, or if this information is lost and needs to be replaced.
Name:
Instructions (dose/frequency, etc.):
Name:
Instructions (dose/frequency, etc.):
Medical and mental health providers
It is important to have medical and mental health information written down for those who are not familiar with your history and may be supporting you in the time of a disaster, or in case this information is lost.
Name:
Phone number:
Address:
Name:
Phone number:
Address:
Name:
Phone number:
Address:
Additional information, resources, and equipment that support our family’s communication, independence, and safety (e.g., hearing aid/special approach instructions/allergies/dietary):
Designated meeting place
Think about a location near home, school, work, or a frequently visited place. Choose a place that would be easy to get to during an emergency. It is important to have a designated meeting place beforehand, in order to make reunification easier.
Name of place:
Address:
Phone number:
Identified Landmark (ex: Target by Grandma’s House):
Name of place:
Address:
Phone number:
Insurance information
It is important to have insurance information written down in case this information is lost or needs to be replaced.
Name on insurance card:
ID:
Group number:
Your pharmacy:
Pharmacies accepted by insurance:
Important phone numbers (police/fire/non-emergency)
It is important to know your community’s emergency and non-emergency numbers in case of an emergency.
Name:
Number:
Name:
Number:
Name:
Number:
Name:
Number:
Important phone numbers inside the home (caregiver(s)/family/friends/etc.)
It is important to have numbers written down in case you need to contact them during an emergency.
Name:
Number:
Name:
Number:
Name:
Number:
Name:
Number:
Emergency contact outside the home (aunt/uncle/sister/friend/teacher/etc.)
It is important to have emergency contacts from outside your home written down in case you need to contact them during an emergency, or in case those inside the home are unavailable or you need extra support. Provide pictures if necessary so children can identify family members that they only know by a title such as “grandma”.
Name:
Number:
Name:
Number:
Name:
Number:
Identified coping strategies
Coping skills are methods that help you move back into a calm state when feeling stressed. An example could be a grounding or breathing technique. Make sure what is listed is age and developmentally appropriate. For best results, it is recommended these skills are practiced before a disaster.
Coping skill 1:
Coping skill 2:
Coping skill 3:
Comfort items:
Optional information on animals in your home
It is important to know information about how to support any animals inside your home in case they have been affected during the emergency.
Service animal information
Name:
Species:
What is the animal trained to do?:
Information about the animal:
Family pets
Name:
Species:
Information about the animal:
Veterinarian:
Address:
Phone number:
Optional information included in a family plan
Religion/faith/culture:
Name:
Phone Number:
Fears and interest (During an emergency, is there anything your child may be afraid of due to past experiences?):
Safety plans (if your child has one):
Accessible transportation (Who can provide?):
Name:
Phone #: