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Coastal Health District Functional and Medical Needs Evacuation Registration Form Note: Please PRINT the entire form and mail it to your county health department. Registration must be updated and
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How to fill out in an actual emergency

01
Stay calm and assess the situation
02
Call emergency services if necessary
03
Follow any instructions provided by emergency services
04
Provide accurate and concise information about the emergency
05
Take necessary actions to ensure personal safety
06
Assist others if possible
07
Wait for further instructions or assistance

Who needs in an actual emergency?

01
Anyone present at the emergency location
02
Victims of the emergency
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Bystanders who can provide assistance
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Emergency service providers and responders

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In an actual emergency, immediate action is required to address a critical situation or event.
All parties involved in the emergency response are required to file a report.
The report must be filled out accurately and promptly to provide necessary information about the emergency.
The purpose of filing in an actual emergency is to document the situation and facilitate a coordinated response.
Details about the emergency, response actions taken, and any impacts or consequences must be reported.
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