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APPENDIX L: EVACUATION FORMS
LONGER CARE FACILITY EVACUATION RESIDENT ASSESSMENT FORM FOR
Adapted from the Shelter Medical Group Report: Evacuation, Care and Sheltering of the Medically Fragile. FACILITY
NAME:DATE:COMPLETED
BY:DATE:LEVEL
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How to fill out appendix l evacuation forms
01
Start by obtaining a copy of the appendix l evacuation forms from the appropriate authority or organization.
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Read the instructions carefully to understand the purpose and requirements of the form.
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Begin filling out the form by providing your personal information such as your name, contact details, and any other required identification information.
04
Specify the location or address from where the evacuation is taking place.
05
Indicate the date and time of the evacuation.
06
Provide details about the type of emergency or event that triggered the need for evacuation.
07
Mention the number of people to be evacuated and any special considerations for individuals with disabilities or medical conditions.
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If necessary, provide additional information or explanations in the designated spaces provided.
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Sign and date the form to certify the information provided.
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Submit the filled out appendix l evacuation form to the designated authority or organization as instructed.
Who needs appendix l evacuation forms?
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Appendix l evacuation forms are typically required by organizations and authorities responsible for emergency management and evacuation plans.
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These forms may be necessary for individuals, families, or groups who need to be evacuated from a location during emergencies such as natural disasters or other hazardous situations.
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Specific groups that may require these forms include residents in high-risk areas prone to floods, fires, hurricanes, earthquakes, etc.
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Additionally, businesses, educational institutions, healthcare facilities, and government agencies may also need to fill out appendix l evacuation forms to ensure the safety and well-being of their employees and occupants.
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What is appendix l evacuation forms?
Appendix L evacuation forms are documents used to report emergency evacuation procedures and plans in case of a disaster or emergency situation.
Who is required to file appendix l evacuation forms?
Businesses and organizations that have employees or residents on site are required to file appendix l evacuation forms.
How to fill out appendix l evacuation forms?
Fill out the required information regarding evacuation procedures, emergency contacts, assembly points, and any other relevant details.
What is the purpose of appendix l evacuation forms?
The purpose of appendix L evacuation forms is to ensure that proper emergency evacuation procedures are in place and that everyone on site is aware of what to do in case of an emergency.
What information must be reported on appendix l evacuation forms?
Information such as evacuation routes, assembly points, emergency contacts, and any special assistance needed for individuals should be reported on appendix L evacuation forms.
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