Senior Emergency Kit Worksheets and Checklists - Caregiver ... This is an accessible emergency contact list template to compile a printable list of important contact information. 4 The "List of national operational contact points responsible for the receipt, transmission and processing of urgent reports on incidents involving harmful substances, including oil from ships to coastal States" contained in the circular is updated at the end of Emergencies can create a variety of hazards for workers in the impacted area. Please be honest when completing this form. Free Printable Emergency Contact List. Emergency phone list comes in 2 colors. Please complete the following information to ensure we maintain a current record of contact information for you and your emergency contacts. Use the Internet to communicate by email, Twitter, Facebook, and other social media networks. PDF. With the benefits that this form can provide whenever an emergency arises, you should make sure that you . PDF DISASTER PREPAREDNESS For Seniors By Seniors FREE 26+ Emergency Contact Forms in PDF. BASIC CONTACT INFORMATION PDF A guidebook intended for use by first responders during ... & type of packages 1 tanktruck un1219 isopropanol 12 000 liters quantity 3 ii hazard class or division no. Today's Date: _____ Job Information Title/Position: Download or preview 1 pages of PDF version of Emergency contact numbers template (DOC: 83.9 KB | PDF: 25.4 KB ) for free. General Emergencies: 911. PDF Emergency Response Guidebook - EMS.gov By planning ahead you Phone Number #6: Your Utility Company. Information such as emergency contacts, medical data and a medical conditions list are easily available with this wallet card. Download or preview 1 pages of PDF version of Emergency contact numbers template (DOC: 83.9 KB | PDF: 25.4 KB ) for free. Shelters and Emergency Housing Contact List Nashville Room in the Inn's Campus for Human Development 705 Drexel St. Nashville, TN 37202 Email (615) 251-7019 Diversified services network and broad range of support for the homeless or those in transition Nashville Catholic Charities Catholic Charities of Tennessee, Inc. 30 White Bridge Road 100: FIRE. If you don't see a teachers printable design or category that you want, please take a moment to let us know what you are looking for. An Emergency Contact List is a detailed record of relevant phone numbers and authorities in emergency situations. The medicines in the list should be administered to emergency patients only treated in the health institutions, I will be responsible for all charges not covered by insurance. Your insurance company. Emergencies may be due to a natural disaster, weakness in a person's health, and even accidents caused by carelessness. List of Emergency Numbers & Calling Codes Around the World ☎️ Emergency numbers list including the local/in-country emergency telephone numbers for the police, ambulance and fire services for countries/territories worldwide.. ADDucation's emergency phone number list is compiled by Joe Connor, last updated 20 Jul 2021.; The international country codes for emergency numbers are . Information you will need to know: Location, Phone Number, Type of emergency, and name of those involved. Customize & Print 101 Backgrounds Available. The list of emergency medicine has been developed though various consultative meeting and workshops with concerned health professionals and institutions. Author: Coty, Aspen Created Date: 11/2/2021 2:47:10 PM . Methods to Account for [Company Name's] Employees Employees have been instructed to meet at a designated location so they can be accounted for on the project. 2 Disaster Preparedness for Seniors by Seniors n The Three Steps to Preparedness Disasters can happen at any moment. The Word, Excel and PDF options are editable and typeable. Travel / Road Information: State highway traffic and weather information is available by dialing 5-1-1 from most phones. BAKER. List locations of propane on this site: _____ III. 73+ FREE FORM Templates - Download Now Adobe PDF, Microsoft Word (DOC), Excel, Google Docs, Apple (MAC) Pages, Google Sheets (SPREADSHEETS . MY Emergency Contact List (Psychological Services) Mental Health First Responders (MHFR) Provides free online peer and family support Visit their website: Western Visayas Psychosocial Support for COVID-19 (Iloilo City) Provides psychosocial support for all affected by COVID-19 Visit their website: Western Visayas Medical Center - Department of Psychiatry Provides mental health support for . Emergency Management: Facility Emergency Plan Template Emergency Equipment If there is no emergency equipment in the building or area state "no emergency equipment" and delete the rest of the section. File Format. Here is a list of the best same templates that you can download for free. March 1990 S-500. n Emergency Contact Page Disaster Preparedness for Seniors by Seniors 35704.DISAS.PREP.SEN32P.indd 1 7/23/09 4:49:35 PM. 7.2 List all the names and contact details of your employees. These communication channels allow you to share information quickly with a widespread audience or to fnd out if loved ones are OK. Currently, there's no single emergency number in South Africa so it's very important for you to have the correct contact details handy for a speedy response to your specific emergency. Phone number. of Natural Resources: Spill Line (317) 233-7745 Monroe County Health Department (812) 349-2543 John Langley, Bloomington City Utilities Numbers are at your emergency contact information in time of printing press the interactive programs and what does it Neckerchief slides are three emergency contact list template contact list is printing. Name: Primary Contact #: Alternate Contact #: (Note: If you have more than 10 employees, you might want to set up a . Emergency medical services responders now look for such numbers in cell phones and call the number if need be. I agree to review and update this information whenever a change occurs and at least every 6 months. Local Emergency Number: 9-1-1 or. There are many types of such lists such as customer contact list, a vendor contact lists, a suppliers' contact list, emergency contact list and students or . emergency contact 1-000-000-0000 no. 102: Disaster Management Services. MY Emergency Contact List (Psychological Services) Mental Health First Responders (MHFR) Provides free online peer and family support Visit their website: Western Visayas Psychosocial Support for COVID-19 (Iloilo City) Provides psychosocial support for all affected by COVID-19 Visit their website: Western Visayas Medical Center - Department of Psychiatry Provides mental health support for . I consent for the emergency contact person listed above to ACT ON MY BEHALF until I am available. School Emergency Plans Know your children's school emergency plan: • Ask how the school will communicate with families during a crisis. Directions: • Print out a card for every member of your valuable household and one to provide your out-of-area contact. Available for PC, iOS and Android. Contact your children's school or day care center to discuss their disaster pro-cedures. Updated July 1, 2021 . But since this 28 emergency Contact list is dedicated to your family, it must be important too for the whole member. Changes highlighted in yellow. I agree to leave an emergency phone number so that the ELC staff may contact me if needed. 5. Emergency Contact: One of the most important elements is the employee's emergency contact list. Size: 53 KB. ): No. Download Emergency Contact Phone List Template pdf. Doctor Visit Worksheet (PDF 592k) Senior Emergency Wallet Card. 2. The authorities who are responsible for handling emergencies are commonly the . This section is for tracking purposes. forward your home phone number to your mobile phone number. • Refer to the contact list Report to: o Coast Guard stations Galveston 409-766-5633 • NOAA Emergency spill contact: Emergency Response Division (ERD) Phone (24-hour): (local contact #) District 8 • E. State Contacts: State's often have minimums for reporting spills. • Program 1-800-42-HANDI into your cell phone in case you need information on available HTCs in areas to which you might have to evacuate. 7.1 Include your own business information. This address and phone list template provides space for physical and email addresses as well as three phone numbers. Emergency Contact Information . And the easiest way to create one is to download and use a free sample contact form designed specifically for emergency contacts. Great for babysitters and kids. Your contact list could be written on a sheet of paper, a booklet, a notebook, or on your phone. Structure Type Location (address, if applicable) Emergency Response Organization* (if available within 30-minute response time) Emergency Response Organization(s): Name Phone Number_____ Emergency Contact Forms in .DOC format. An emergency is the term used when there is a certain situation that requires an immediate response. Fill, sign and download Employee Emergency Contact Form online on Handypdf.com To reach the American Association of Poison Control Centers, call their helpline at 1-800-222-1222. • Program your emergency contact into your telephone under "ICE" (In Case of Emergency). List structures maintained by site personnel (tower, river gauge, etc. EMERGENCY CONTACT LIST www.trushield.ca YOUR BUSINESS INFORMATION Name of Facility: Street Address: City, Province & Postal Code: Telephone Number(s): FACILITY MANAGER . Leave this emergency contact list with a babysitter or house sitter to be sure they know who to call if something goes wrong. There are 101 backgrounds and 8 contact lists. ): No. Police department Fire department Poison control Animal poison control Hospital Emergency Numbers Water company Power company Insurance company Doctor Local EMS Tow truck Veterinarian Animal control Locksmith Important Numbers Neighbor #1 Name Neighbor #2 Name Personal Records Appendix A: Emergency Contact List Bloomington SPCC Facility Response Coordinator (IUEHS) (812) 855-6311 Night 911 National Response Center (800) 424-8802 Indiana Dept. Be sure to have your local poison control number available in the case of an emergency. page 1 for divisions 1.1, 1.2, 1.3, or 1.5 use guide 112 (a) emergency telephone numbers and procedures are posted in a prominent place in the licensee's child care centre; Guideline The following telephone numbers shall be posted in the child care centre: (a) fire department (include non-emergency numbers) (b) police department (include non-emergency numbers) (c) nearest hospital (including address) Simply locate your county or town/city, and you'll find a pre-planned list to get you started as you develop your own emergency plan. Emergency preparedness is a vital part of operating a business. Fold Here . EMERGENCY CONTACT FORM Mobile phone List any medications hat must be carried into the facility: List any condition that may require emergency attention and medications that you may be allergic to: Affiliation Emergency contact name Relationship Home phone Work phone Emergency contact name If it is determined that any employees are missing, the responding emergency agency will be notified. emergency care. This is where the employee will provide the person to be contacted in an emergency. home-storage-solutions-101.com This template is the simplest contact list to maintain, it's called the most important contact list. reporting 911 life-or-limb-threatening emergency, and that by signing this form, I have given my express consent to do so. Emergency contact list. Remember to include your insurance information on your list, including your insurance company's name, their claims hotline phone number, and your policy number. Emergency Wallet Card (PDF 210k) Download the complete Senior Emergency Toolkit . 1091: Women Helpline - ( Domestic Abuse ) 181 Emergency Contacts. Facility Contact Information Emergency Care and Urgent Care Providers: Updated 3/13/2020 Page 1 of 18 State City Facility Name Daytime Phone Number for Community Care Provider Notifications and Questions After Hours Contact Phone Number for Community Care Provider Questions (Manned 24/7 - Suggest AOD) . Doctor Visit Worksheet (PDF 592k) Senior Emergency Wallet Card. • Fill in your emergency contact information. Fillable and printable Employee Emergency Contact Form 2021. No more wasted paper. Baker County Emergency Management Baker County Courthouse example of emergency contact telephone number id number shipping name packing group. 24 HOUR EMERGENCY PHONE NUMBER As soon as possible, the water system (Manager) or (other designated person/s) should notify all consecutive systems to which water is sold of the emergency situation and advise them of what steps are being taken to deal with the emergency. When an emergency situation arises, it's important to have key numbers posted so that employees know who to contact to assist . 1 . 108: Women Helpline. 7. If available, all numbers listed are 24-hour emergency numbers. Start a Free Trial Now to Save Yourself Time and Money! 2. No matter how prepared your camp staff is, there may be an accident that requires you to call a camper's emergency contacts. NATIONAL EMERGENCY NUMBER: 112: POLICE. This free printable emergency contact list is a great way for you to organize all the information your household will need when an emergency strikes. School Emergency Plans Know your children's school emergency plan: • Ask how the school will communicate with families during a crisis. EMERGENCY CONTACT LIST In the case of a life-threatening emergency, call 911. Emergency information forms are very useful in instances like accidents and unforeseen circumstances where medical help is needed. Please complete the following information to ensure we maintain a current record of contact information for you and your emergency contacts. In case you can't contact an employee's phone, social media, or email, at least HR can refer to the employee's list of emergency contacts, may it be the worker's spouse, family, or best friend. Methods to Account for [Company Name's] Employees Employees have been instructed to meet at a designated location so they can be accounted for on the project. Emergency Contact List Guidelines: First of all, you need to decide if you are making this list for yourself or for a workplace like an office or warehouse. 7 Tips for making a contact list template for your business. During an emergency no one wants to be scrambling to find information. Knowing your insurer's contact information can help you jump-start the claims process and get your business up-and-running after an emergency. LOCAL AND TRIBAL EMERGENCY MANAGERS . 7.4 Also, include the utility companies. & type of packages un1219 isopropanol 12 000 liters 1 tanktruck quantity 3 ii id number shipping name packing group hazard class or division no. Note 22 CCR, Section 66265.52(e) [ as referenced by Section 66262.34(a)(3)] and the Information such as emergency contacts, medical data and a medical conditions list are easily available with this wallet card. I also understand that as soon as possible following my child's accident or illness, an ELC staff member will contact me. The time you waste looking for information could be deadly. This template helps to maintain data like name, address, phone number, email id and special notes if any of all your important contacts be it personal or professional. Keep emergency information quickly available wherever your loved one goes. Download. Appendix A: Emergency Contact List Bloomington SPCC Facility Response Coordinator (IUEHS) (812) 855-6311 Night 911 National Response Center (800) 424-8802 Indiana Dept. To change the contact list, go to planner inserts and select "contact lists". At the top of the list, distinguish one name from others which will be the first choice of people to call and if there is no answer to that number, then it's time to go down the list . Emergency Contact Information Form This information will be extremely important in the event of an accident or medical emergency. page 1 how to use this guidebook resist rushing in ! gencies, including understanding how you will be provided emergency and warning information. Made in the USA *Just write, peel, and stick *Sticks to walls, cupboards, or fridge *Removable *Use a FINE tip PERMANENT marker *Easy to erase with 91% alcohol. Consecutive System Operator Office/Home Phone . Once notified, Team members will gather at the location of the disaster or alternate location if necessary and will begin to carry out responsibilities defined below. Keep emergency information quickly available wherever your loved one goes. During a power outage or a suspected gas leak, you might immediately think to call 911. And although first responders can generally help in these situations . ADULT EMERGENCY CONTACT AND MEDICAL FORM The information requested on this page is confidential and for emergency use only. other persons to be notified in emergency name address telephone a. physician ( ) b. mental health provider, if any ( ) c. dentist ( ) d. relative(s) ( ) e. friend(s) ( ) 9. emergency hospitalization plan . Preparing before an emergency incident plays a vital role in ensuring that employers and workers have the necessary equipment, know where to go, and know how to keep themselves safe when an emergency occurs. Name: Primary Contact #: Alternate Contact #: EMPLOYEES . Employee Contact Information Form . In the event of an emergency, this information will be used by program staff and emergency personnel. of Natural Resources: Spill Line (317) 233-7745 Monroe County Health Department (812) 349-2543 John Langley, Bloomington City Utilities Personal and Emergency Contact Information Form. 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